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ANNALS OF 
MEDICAL HISTORY 

VOLUME II 

SPRING, SUMMER, AUTUMN 
AND WINTER 

1919 



I 



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G>\M 



ANNALS OF " 

EDITOR: FRANCIS R. PACKARD, M.D., Philadelphia, Pa. 

ASSOCIATE EDITORS 

HORACE MANCHESTER BROWN, M.D. . Milwaukee 

HARVEY CUSHING, M.D Boston 

CHARLES L. DANA, M.D New York 

GEORGE DOCK, M.D St. Louis 

♦MORTIMER FRANK, M.D Chicago 

FIELDING H. GARRISON, M.D. .... Washington 

♦ABRAHAM JACOBI, M.D New York 

HOWARD A. KELLY, M.D Baltimore 

ARNOLD C. KLEBS, M.D Washington 

*SIR WILLIAM OSLER, M.D Oxford 

WILLIAM PEPPER, M.D Philadelphia 

LEWIS STEPHEN PILCHER, M.D. . . . Brooklyn 

DAVID RIESMAN, M.D Philadelphia 

CHARLES SINGER, M.D Oxford 

EDWARD C. STREETER, M.D Boston 

CASEY A. WOOD, M.D Chicago 

♦Deceased. 



VOLUME II 



NEW YORK 

PAUL B. HOEBER, PUBLISHER 

67-69 EAST 59th STREET 



2Jff-5"«'U 



COPYRIGHT, 1920. 

By PAUL B. HOEBER 



ANNALS OF MEDICAL HISTORY 

VOLUME II 

CONTENTS SPRING NUMBER PAGE 

Anatomists in Search of the Soul George W. Corner ... i 

The Medical Gods of Ancient Iran Walter A. Jayne .... 8 

The "Pulmotor" of the Eighteenth Century . J. Collins Warren ... 14 

The Birthplace of the Hunters Fielding H. Garrison . . 21 

Two Chapters in the History of Laryngology 

and Rhinology James J. Walsh .... 23 

Modern Commentaries on Hippocrates .... Jonathan Wright .... 34 
A Descriptive List of the Incunabula in the Li- 
brary of the College of Physicians of 

Philadelphia Charles Perry Fisher . . 44 

Editorials 

Rene Theophile Hyacinthe Laennec (1 781-1826) 79 

Henry E. Handerson's "Gilbertus Anglicus" Francis R. Packard ... 79 

Historical Notes 

Currie's "Journal" . William Osier 81 

Local History Francis R. Packard ... 82 

Pasteur Dramatized Francis R. Packard ... 83 

Book Reviews 

Weber. Aspects of Death and Correlated Aspects of Life in Art, 

Epigram, and Poetry 84 

Good. Benjamin Rush and His Services to American Education . . 85 

Moore. The History of St. Bartholomew's Hospital 86 

Correspondence 

Packard. The Sterility of Catherine de Medici 91 

SUMMER NUMBER 

Photogravure of Abraham Jacobi from a Photograph by Doris U. 

Jaeger Frontispiece 

A House-Surgeon's Memories of Joseph Lister . S{ Clair Thomson ... 93 

The Oxford Physic Garden D'Arcy Power 109 

Modern Commentaries on Hippocrates .... Jonathan Wright .... 126 
The Rise and Early History of Clinical Teach- 
ing David Riesman . . . . 136 

Napoleon's Camp at Boulogne •. . Reginald Fitz 148 

William Osler, the Man Harvey Cushing . . . . 157 



CONTENTS 

PAGE 

Sir William Osler, a Tribute Howard A. Kelly . . . 168 

Osler's Influence on Medical Libraries in the 

United States » John Ruhriih 170 

Sir William Osler's Contributions to Medical 

Literature Fielding H. Garrison . . 184 

Presentation to Sir William Osler, F. R. S 188 

Additions to the List of Incunabula in the Li- 
brary of the College of Physicians, Phila- 
delphia Charles Perry Fisher . . 191 

Editorials 

Abraham Jacobi (1830-19 19) Fielding H. Garrison . . 194 

Memorial Notice : Mortimer Frank . . . Fielding H. Garrison . . 206 

Lord Lister Francis R. Packard . . . 208 

La Societe Francaise d'Histoire de la Mede- 

cine Francis R. Packard . . . 209 

Historical Notes 

Exhibitions at the Classical Association 211 

FALL NUMBER 

Portrait of William Paul Crillon Barton Cover 

Ancient Poems on Infant Hygiene John Foote 213 

Walter Harris, a Seventeenth-Century Pedia- 

trist John Ruhriih 228 

New Observations in Paleopathology .... Roy L. Moodie . . . . 241 
Jean Paul Marat, Physician, Revolutionist, 

Paranoiac Charles W. Burr .... 248 

An Appreciation of Henry Bence Jones, M.D., 

Ph.D Jacob Rosenbloom . . . 262 

The Finances of Felix Platter, Professor of 

Medicine at Bale Charles Greene Cumston . 265 

William Paul Crillon Barton, Surgeon United 

States Navy, a Pioneer in American Naval 

Medicine Frank Lester Pleadwell . . 267 

Editorials 

A Physiological Romance . Francis R. Packard . . . 302 

I ER CONGRES DE L'HlSTOIRE DE MeDECINE 302 

Biography of Sir William Osler Harvey Cushing .... 303 

Book Reviews 

Pino and Roca. Breves Apuntes para la Historia de la Medicina; sus 

Progresos en Guayaquil 304 

vi 



CONTENTS 

PAGE 

WINTER NUMBER 

Portrait of Daniel Turner Cover 

Sculpture and Painting as Modes of Anatomical 

Illustration Fielding H. Garrison and 

Edward C. Streeter . . . 305 

The Quintessence in Rabelais Douglass W. Montgomery . 330 

Thomas Phaer John Ruhrdh 334 

Statements of Medical Interest from the Life 

of Benvenuto Cellini Jacob Rosenbloom . . . 348 

Daniel Turner and the First Degree of Doctor 

of Medicine Conferred in the English Col- 
onies of North America by Yale College in 

1723 John E. Lane 367 

A Neglected Name: Isaac Senter ...... William Abbatt .... 381 

On a Latin Translation of the Complete Works 

of Galen by Andrea Laguna, M.D., the 

Spaniard, Strassburg, 1604 D. Fraser Harris . . . 384 

Editorials 

A Group of Books Dealing with the History 

of Medicine in England Francis R. Packard . . . 391 

Dr. Georges Clemenceau Francis R. Packard . . . 392 

Editorial Note 393 

Historical Notes 

A Note on the History of Variolation . . Fielding H. Garrison . . 394 

The Legal Control of the Sale of Nostrums 
and Poisons in France During the Eight- 
eenth Century Charles Greene Cumston . 396 

Book Reviews 

Nias. Dr. John Radcliffe, a Sketch of His Life, with an Account of 

His Fellows and Foundations 400 

Rockwell. Rambling Recollections, an Autobiography 400 

Boutarel. La Medecine dans Notre Theatre Comique, depuis ses 

Origines jusqu'au XVI Siecle 402 

Robinson. The Don Quixote of Psychiatry 403 



VOLUME II 




NUMBER 1 



^ 



ANNALS OF 

MEDICAL HISTORY 



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FRANCIS R'PACKARD'M'D'EDITOR [PHILADELPHIA] 
PUBLISHED QUARTERLY BY PAUL < B < HOEBER 
67-69 EAST FIFTY-NINTH STREET ' NEW YORK CITY 



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Entered as second class matter June 2, 1917, at the post office at New York, N. Y., under the Act of March 3. 1870. 
Yearly Subscription $ 6.00. Sinerle numbers $2.00 



ANNALS OF MEDICAL HISTORY 




Volume ii 



Spring 19 19 



Number i 



ANATOMISTS IN SEARCH OF THE SOUL 
By GEORGE W. CORNER, M.D. 

University of California 




BERKELEY, CAL. 

EAVEN lay about us 
in the infancy of our 
race. When the mind's 
eye of the tribesman 
first opened upon a 
world of mystery, to 
him the haunts of 




good and evil spirits 
lay no farther away than the jungle just 
beyond his hut. The jungle explored, the 
river followed to its head, mountain sum- 
mits still remained untrodden, and here for 
a while dwelt the gods. Olympus at last 
ascended and found to be a vacant peak, 
the mountain-climber came down, his 
disappointment forgotten, to tell of gazing 
across a vast ocean and of the Blessed Isles 
which seemed to lie therein, beyond the 
setting sun; and when mariners returned 
without news of such far shores, there were 
still the stars and the sun-god's chariot of 
fire, beyond the reach of any mortal traveler. 
So with the inward mystery of man's 
life; at first a mere wraith of fancy or of 
fear, a vague image of the body it in- 
habited, the spirit could wander inde- 



pendently of the flesh, and oftenti 
must be confined by bonds of linen to 
prevent its imminent escape through the 
gash of a desperate wound, or be held 
down with weights of iron upon the head. 
But even here, as into the jungle, the 
explorer came, and began an unending 
search for an ever-receding goal, a search 
which like that other led at first through 
regions nearest home; for two thousand 
years the pious hands of anatomists sought 
the springs of life in the tissues of animals, 
and even attempted to find in the bodies 
of the dead the organic seat of man's 
immortality. 

The first civilized dissectors were those 
Sumerian priests and haruspices who drew 
auguries from the viscera of sacrificial 
animals. In this widespread rite it was the 
liver especially in which the omens were 
sought; while in the earlier thought of the 
races which practiced it, Assyrians, He- 
brews, and Greeks, the liver was also 
considered the seat of life, of heat, and of 
whatever higher faculties distinguished man 
from the animals, and animals from lower 



Annals oj Medical History 



nature. The Psalmist literally said "The 
liver of the. righteous man shall be made 
fat." . . . "My liver shall sing praise to 
Thee and not be silent." The learned 
studies of Professor Jastrow suggest, indeed, 
that it was because of the importance 
attached to this organ as of sacred function, 
that the rite of liver-searching became so 
general and finally led, its original signifi- 
cance forgotten, to the immolation of ani- 
mals with the more elevated conception of 
vicarious sacrifice. How in the first place 
the liver earned such important rank among 
the tissues, takes us perhaps into too dark 
a region of primitive symbolism, but where 
the philologist did not tread, a casual 
wanderer in this field may rashly enter. 

Primitive man, opening the abdomen 
of a beast, saw much that explained itself. 
The stomach, the intestines, the kidneys, 
bespoke their own functions by their very 
contents or their connections, and being 
understood, were no cause for wonder. 
But the liver — largest and heaviest mass 
of all, blood-hued, and as it seemed, the 
source of all the veins; with spreading 
lobes and the strangely colored vessel of 
gall — offered an inviting mystery, and 
could not fail to be the seat of faculties less 
ignobly comprehensible than mere emunc- 
tion or digestion. Was it not, then, the 
source of the blood, of bodily warmth, of 
life itself? 

Centuries later, with the practice of dis- 
section as a scientific method, other regions 
of the animal body were laid bare, and 
heart and brain began to present new 
mystery and new opportunity for the seeker 
of souls. In the Hippocratic writing "De 
corde," the right cavities of the heart are 
represented as receiving the blood from 
the liver and driving it out again through 
the veins; but the left ventricle (found 
empty after death) contains the vital prin- 
ciple or pneuma, which is to be sent through- 
out the body by the arteries. The heart 
is thus the central organ of life and the 



seat of understanding. Other early Greek 
investigators, as Alkmaion of Croton, began 
to have glimmerings of the importance of 
the brain; but even these new organs 
could not entirely dispossess the liver from 
its old place of honor. New philosophies, 
like new religions, build upon the old. 

There were metaphysicians as well as 
anatomists at work upon the problem of 
flesh and spirit; and there soon grew up 
that half-shrewd, half-false doctrine which 
is so clearly expressed by Aristotle, a doc- 
trine which was still taught as fact in the 
Middle Ages, and survives in the etymology, 
though lost to the thought, of the present 
day. Life is of triple nature (says Aristotle) ; 
the plants of the field are nourished and 
grow; beasts feel and move; man reasons 
and remembers, and knows that he exists. 
Possessors of threefold faculties, we live 
and move and have our being, and for each 
faculty an organ is set apart. As the ancients 
knew, the liver is the place of the vegetative 
soul, drawing nourishment from the stom- 
ach, and sending it through the hepatic 
vein to the heart, where its more subtle 
portions are refined to form the sensitive 
soul, whose outward motions are felt in 
all the pulses. Over these lesser organs 
presides the brain, seat of the intellectual 
faculties, the "animal soul." A blow upon 
the head, injury of the brain, may abolish 
for a time all consciousness, but the vital 
spark remains alight until the last beat 
of the heart. 

The anatomical theories upon which all 
this was based were hardly modified until 
the Renaissance, except that discovery of 
the bile-forming function of the liver made 
that organ more or less comprehensible and 
so deprived it of its remaining share of the 
soul. The heart, needless to say, retains 
its old place of honor, if not in the scientific 
sense, at least in the speech of romance 
and of worship. Buried in our language 
are curious traces of this and even older 
philosophies; thus we say "frenzy" of an 



Anatomists in Search of the Soul 



ailment of the mind, but the phrenic 
nerves and vessels are those of the dia- 
phragm — a relic of a pre-Aristotelian view 
that the diaphragm, placed between liver 
and heart, was itself the seat of the intellect. 

The higher functions once established in 
the brain, the search was narrowed, and 
every recess of the cranium was invaded. 
At Alexandria, in the third century before 
Christ, Erasistratus and Herophilus added 
to other great achievements an exact study 
of the human brain. The first was the dis- 
coverer of the meningeal coverings, and 
placed in them the intellectual faculty, 
but later transferred it to the cerebellum, 
partly, we may suppose, because of its 
marvelous structure still called arbor vitse, 
but also because he had seen the grave 
results of damage done to the cerebellum 
in animals. Herophilus went deeper, dis- 
covered the ventricles of the cerebral hemi- 
spheres, and gave to them the same inter- 
pretation, whence perhaps arose the quaint 
mediaeval division of the brain-cavities into 
cells of imagination, reason, and memory. 
But most striking guess of all was Strato's 
of Lampsacus, who found, so Plutarch tells, 
the pars princeps animse in the middle of 
the forehead, between the eyebrows. We 
need no flight of fancy to imagine his joy 
and awe, who must have been the first 
to drive chisel into the frontal sinuses. 
In the very substance of the skull, between 
brain and eye, where thought and vision 
meet, those dark caverns might well have 
seemed to him the abiding place of man's 
inner self. 

But the inner self of these ' Greeks was 
in general no more than what we vaguely 
mean by the word life, without clear 
implication of anything immaterial. When 
the coming of Christianity, on the other 
hand, brought back in a nobler form that 
conception of the soul as an immortal 
entity, as a temporary dweller in the house 
of flesh, which is found alike in the thought 
of the savage and in the speculations of 



Plato, it freed the soul from the trammels 
of body for eternity, yet it bound the spirit 
subject to the flesh during the span of 
earthly existence; and herein it raised a 
strange new problem for the anatomists 
of the soul. 

The Christian Fathers did not seek new 
organs for the new soul; anatomy was 
stagnant, and they went to pagan Galen 
for physicians' lore as trustingly as to 
their sacred codices for texts. To many, 
indeed, the intellectual or animal soul, 
already firmly seated in the brain, was 
itself the immortal essence, though others 
imagined this a fourth entity for which 
Galen could have given them no new organ 
had they sought one; wherefore, with 
Augustine, they let it be diffused through- 
out the body. Thus it was not toward the 
science of completed form the Latin Fathers 
turned, but to embryology, for they were 
greatly troubled to know in what manner 
the soul comes at first to join the body. 
Whether created anew by God, or having 
waited from the beginning among a great 
throng of the other unborn; whether in- 
herited from the parents, or given to the 
child at the moment of its first breath, or 
infused into the unborn embryo, were 
questions of vast argument. 

In the debate TertuIIian and Augustine 
were foremost; but it is curious that with 
all their insistence upon spiritualities, the 
only evidence they had to prove the pres- 
ence of the soul in the embryo before birth 
was based upon such purely corporeal 
grounds as the early development of brain 
and heart and the existence of muscular 
movements in utero. There is a quaint 
account of the formation of the embryo 
which appears in a long series of books, lay 
and ecclesiastical. Aquinas took it from 
Augustine, who knew it perhaps from some 
forgotten physician of the third century; 
Dante from Aquinas, and versified it in 
his Purgatory. Henri de Mondeville put it 
in a book of surgery, and from him Thomas 



Annals oj Medical History 



Vicary gave it English words: "Thus is 
the childe bred foorth in four degrees . . . 
the thirde degree is, when the principals 
be shapen, as the Hart, Iyver, and Brayne: 
the fourth and Iaste, as when al the other 
members be perfectly shapen, then it re- 
ceyveth the soule wyth life and breath; 
and then it beginneth to moue it-selfe 
alone: so is ther xlvj. dayes from the daye 
of conception vnto the daye of ful perfection 
and receyving of the soule, as God best 
knoweth." 

It is obvious that the embryology of 
Augustine finds a practical application in 
the question of infant damnation; the 
spirit is almost eight months a prisoner 
liable to the penalties of unchristened 
death, but without opportunity of rescue 
by baptism. Here is no place for the tender- 
hearted — or for the anatomist. Yet to 
this day, when birth is impending in any 
household of the Church, the physician 
must be prepared to utter the hallowed 
formula, and in times of emergency, when 
two lives are committed to the hands of the 
surgeon, there takes place a dramatic 
repetition of the immemorial battle for 
souls. The unorthodox physician who has 
witnessed or taken part in one of these 
sudden tragedies will be driven to marvel 
at the power of an ancient dogma in the 
modern hospital; the basin of sterile salt 
solution becomes, by miracles of faith, a 
baptismal font, and solemn adjuration of 
Father, Son, and Holy Spirit issues from the 
swathed figure of a nursing Sister. But those 
who believe must almost have heard din 
of warfare and have seen the glitter of 
archangels' panoplies. 

We have had more than a hint that in all 
times past the search for the soul has followed 
the same path, every new seeker passing 
over the familiar ground traversed by his 
predecessors, thinking the object of his 
hope lay in some place beyond, still mys- 
terious and unexplored. Yet at first thought 
no time would seem less likely to witness a 



renewal of the old search than the middle of 
the seventeenth century, nor would any 
man seem less likely to pursue it than one 
whose very methods of reasoning were 
founded upon an attempt to abandon older 
ground. In 1543 Vesalius' "Fabrica" had 
broken anatomy's age-old chains of tra- 
dition, and eighty-five years later Harvey's 
discovery of the circulation threw her 
shackles to the ground. After this the 
pulse-beat was not mysterious, and no more 
is heard of a soul in the heart or the arteries. 
It was otherwise with the nervous system, 
however, for not even the genius of Vesal 
could fathom the problem of muscles moving 
at the command of the will, nor tell how 
a pin-prick gets into consciousness. More- 
over, there was nothing, as yet, in the 
new anatomy to replaoe or even to discredit 
the Galenic doctrine of the animal spirits, 
which taught that in the brain the more 
volatile parts of the blood are filtered out 
and sent ebbing and flowing through the 
nerves (believed to be hollow) to carry 
sensation and volition back and forth. It 
was in the minds of many that somewhere 
in the brain, at the starting-place of this 
living tide, must be the central point of 
existence; for all his originality, Rene 
Descartes too was moving in the well- 
trodden path when he made his famous 
assumption that the pineal gland is the 
seat of the soul. His reasons are hardly 
more than Erasistratus or Strato might 
have given: there must be some point at 
which body and soul are joined; it must 
be a single structure, and in the middle 
plane of the body, in order that impressions 
coming from double organs, like the eyes or 
ears, may be combined into a single thought; 
the pineal gland is the only organ in the 
brain which his dissections had shown to 
be so placed; it lies in the third ventricle, 
in the very spot where the spirits of the 
anterior cavities meet those of the posterior, 
and it is well protected from outward 
harm. 



Anatomists in Search of the Soul 



That Descartes' emphasis upon the mid- 
dle of the head was in accord with the 
notions of the times we might bring many- 
things to show. The most amusing illustra- 
tion which comes to mind is in a book on 
hermetics and astrology by Robert Fludd, 
Doctor of Medicine at Oxford, "De super- 
natural^ naturali, prseternaturali, et con- 
tranaturali microcosmi historia," 1619. In 
a full-page engraving is shown a man's 
head and hand in profile, with dotted lines 
connecting the organs of the five senses 
with mystic circles representing the material 
world. Upon the temples are two circles 
inscribed sensativa, imaginativa, and in the 
oval where they overlap, the sentence hie 
anima est. Upon the occiput are two other 
circles, memorativa and motiva, and again 
hie anima est. In the middle of the head 
(not far above the region of the pineal 
gland) are concentric circles, mens, intel- 
lects, ratio; overlapping circles, cogitativa 
and aestimativa, and for the third time 
hie anima est; but from this middle soul 
there are dotted lines leading heavenward 
to radiant niches marked with names of 
angels and archangels, powers and prin- 
cipalities, thrones and dominations and the 
Persons of the Trinity. 

Bartholin and Wharton, two of the best 
anatomists of the time, offered prompt 
objection to the pineal gland theory, on 
grounds no more subtle than Descartes' 
own. First, they urged, this little body, no 
more than twenty grains in weight, is too 
small to contain all the images of the soul. 
More to the point is their second objection, 
that the external nerves do not arise from 
the glandula pinealis, but from the spinal 
marrow, and thus anatomical study does not 
show how the animal spirits can pass into 
them from a structure so deeply placed. 
The third objection is based on the entirely 
rantrue, but more striking notion that the 
cerebrospinal fluid of the third ventricle 
is refuse matter from the process of refine- 
ment of animal spirits, and hence Descartes 



was locating the soul in a place of excre- 
ments. Other anatomists discovered the 
frequent presence of small gritty concretions 
in the pineal body, which somehow made 
that structure more sordid, less fit to be 
the seat of a great function. 

These criticisms did not invalidate the 
methods, but only the results of the great 
philosopher's anatomy; and there seems to 
have been something fascinating about the 
Cartesian rules for discovering the soul 
that set all his friends dissecting as well. 
Two English relics of their search survive 
under the dust of libraries, which seems 
to lie thickest upon books of outworn 
philosophy. Sir Kenelm Digby found time, 
amid a life of experimenting in alchemy, of 
privateering in the Mediterranean, of pro- 
moting the most preposterous of all secret 
nostrums, writing cook-books, and of duel- 
ing, to visit Descartes and to write two 
thick treatises, "Of Bodies," and "Of Man's 
Soul," which are very treasuries of ver- 
bosity and of question-begging. Such a 
man, from pride of intellect alone, could 
not fail to take part in the search, and his 
solution was the septum pellucidum, the 
membrane or partition of cerebral sub- 
stance which divides the right from the left 
lateral ventricle of the hemispheres. Digby's 
reasons, from first to fifthly, are too palpably 
like Descartes', but the last two are of a 
quaintness worthy quoting: "Sixthly, it 
is seated in the very hollow of the brain: 
which of necessity must be the place and 
receptacle, where the species and simili- 
tudes of things reside; and where they are 
moved and tumbled up and down, when 
we think of many things. And lastly, the 
situation we put our head in, when we 
think earnestly of any thing, favours this 
opinion: for then we hang our head for- 
wards, as it were forcing the specieses to 
settle towards our forehead; that from 
thence they may rebound, and work upon 
this diaphanous substance." 

Dr. Henry More's "Treatise on the Im- 



Annals of Medical History 



mortality of the Soul" came from the 
seclusion of a fellowship in Christ's College, 
Cambridge. To him, as to Descartes, the 
soul is in the whole body, but that part 
of it which is called the common sensorium, 
wherein our five senses are joined in one 
understanding and reasoning faculty, must 
have a special seat in the brain. More 
would place it in "those purer animal 
spirits in the fourth ventricle of the brain." 

The "Anatome Corporis Humani" of 
Isbrand van Diemerbroeck, professor at 
Utrecht, printed in 1672, would appear 
to be the last textbook which discussed the 
question of the soul as part of a routine 
description of the human body. After this 
the soul disappeared from the scope of 
anatomy as heaven had vanished from 
the maps of terrestrial geographers. Acuter 
insight began to distinguish the study of 
the mind's activities from pursuit of the 
soul, keener eyes began to trace the intri- 
cacies of the nervous system; and scholars 
came at last to share the opinion of Sir 
Thomas Browne: "In the brain, which 
we term the seat of reason, there is not 
anything of moment more than I can dis- 
cover in the crany of a beast: and this is 
no inconsiderable argument of the inor- 
ganity of the soul, at least in that sense 
we generally so receive it. Thus we are 
men, and we know not how." 

The sober hypotheses formed and dis- 
carded at one period of thought often 
remain alive in the belief of the credulous of 
a later time. Many pious enthusiasts still 
have great faith in the results of Piazzi 
Smith's attempt to prophesy the future 
by measuring the pyramids of Egypt; and 
in the same way the pineal gland is now 
having a revival of interest in Theosophic 
circles. In 1889, when Madame Blavatsky 
wrote her "Secret Doctrine," she was not 
aware of Herbert Spencer's brilliant dis- 
covery that the pineal body represents an 
undeveloped eye which in a few little- 
known reptiles almost attains perfection 



of form; and since the structure was still 
as inexplicable (lacking this knowledge) 
as it was in Descartes' time, it was eligible 
for any function one might wish to give it. 
So, too, was the hypophysis or pituitary 
body; and in the new doctrine the latter 
was made the seat of a new, sixth sense, the 
power of comprehending unvoiced thought, 
psychic receptivity; while the pineal gland 
will be in later and higher races of our line 
the bodily lodging of the seventh sense, 
divine insight. Between these two struc- 
tures there is a delicate connecting strand, 
whose invisibility to materialistic anatom- 
ists is explained by the statement that it 
is destroyed by shrinkage of the brain 
after death. Contrary to the usual rule, 
scientific investigation did not break down 
these views (as far as the Theosophists 
were concerned) in suggesting more prosaic 
derivations and functions of the two mys- 
terious bodies; the proven relations of the 
hypophysis to bodily growth and the em- 
bryological explanation of the pineal as 
a third eye, when they came, were accepted 
as renewed evidence of their psychic im- 
portance. 

When a devotee by special endowment 
and training acquires the sixth sense, he 
can observe the functioning of another's 
inner processes of soul: "When a man is in 
his normal condition, an adept can see the 
golden aura pulsating in both the centers, 
like the pulsation of the heart. . . . The 
arc of the pulsation of the Pituitary Body 
mounts upward, more and more, until the 
current finally strikes the Pineal Gland, 
and the dormant idea is awakened and 
set all glowing with the pure Akashik Fire. 
Once the sixth sense has awakened the 
seventh, the light which radiates from the 
seventh illuminates the fields of infinitude. 
For a brief space of time man becomes 
omniscient; the Past and the Future, Space 
and Time, disappear and become for him 
the Present." — At this point the skeptic 
listener is tempted to quote Robert Boyle: 



The Essence of the Mediaeval Spirit 



"This seemingly rude lump of soft matter 
does for color and consistence look almost 
like so much custard; yet there are strange 
things performed in it!" 

In this last strange recrudescence, we 
have an epitome of all searching for the 
soul in the body of man. If in this case 
the scientist is more likely to deny than 
to affirm, so has it always been. It is not the 
anatomist who has given us such dreams, 
but rather the mystic or philosopher who 
first created in his own thought an image 
of the soul, and set it down in whatever 
organ of the body seemed at the time most 
mysterious, most free from sordid function, 
nearest the inward fire. Into each of these 



false temples of the spirit the anatomist has 
come by turn, but by the very breaking 
of idols he has helped to win the soul a 
brighter raiment. By the paradox of time 
we also count among the builders those 
who were destroyers, Asclepiades and his 
followers of all ages, who sought by experi- 
ment upon the body to prove non-existence 
of the soul; and against whom the voices 
of the pious have never ceased to be raised. 
So might sun-worshipers have mourned, 
to know that a prism of glass would one 
day prove that great light to come from 
the burning of earth-like minerals; wherein 
we conceive of Majesty exceeding earth 
and sun. 



THE ESSENCE OF THE MEDIAEVAL SPIRIT 



Well indeed may we turn our eyes away 
from those centuries wherein one oj the chief 
callings of man fell into unexampled and 
even odious degradation. . . . In the equal 
eye of history, the Middle Ages teach us that 
slow and painful travail of natural science 
is not to be regarded as the belated labor of light 
in the womb of darkness, nor as a mere 
stifling of the growth of the human mind by 
tyranny and oppression, nor indeed as the 
arming of moral forces against brute forces^ 
but as the condition of time in the making 
of societies on a necessarily provisional theory 
of life. They teach us that conduct in state 
and morals depends upon a theory of life; 
that although habits and even standards of 
ethics may abide for a time after the theory 
on which they were built is sapped, it is but 



for a time; that if the social discipline and 
fruition are to be renewed and enlarged it 
must be upon a new synthesis, as laborious 
and ardent as the former, and more true. 
Meanwhile the business of a nation, whether 
in war or peace, is first to be quick and strong 
in action, to be rational afterwards; and sivift- 
ness and strength come of union of wills and 
singleness of heart rather than wisdom. Even 
within its borders freedom of opinion must 
awaken slowly; the nation strong enough to 
suffer irresolutions in its outward policy has 
yet to appear. Hence it is that we find in ruling 
classes, and in social circles which put on 
aristocratical fashions, that ideas, and espe- 
cially scientific ideas, are held in sincere 
aversion and in simulated contempt. 

Sir Thomas Clifford Allbutt. 



THE MEDICAL GODS OF ANCIENT IRAN 



By WALTER A. JAYNE, M.D., 

DENVER, COLORADO 



(persia) 



IN ancient Iran, disease with its 
treatment was a definite part of the 
religious system. Medical doctrines 
and practices were determined by the 
sacred books and were under the control 
and direction of the priesthood and physi- 
cians. The religion of Zoroaster prevailed 
in Iran, dating from an early period, and in 
its development was highly moral and lofty, 
one of the most interesting of the ancient 
world. This system was dominant and prom- 
ised to spread over the Orient, even to 
Europe, when the ravages following the 
conquest of Alexander the Great (330 
b. c.) checked it and effectually broke its 
power. The "Avesta," the Living Word, 
the sacred book of Iran, is now but a rem- 
nant of the original, and is the holy scrip- 
tures of the Parsees of India. It was a volu- 
minous work in the early days, inscribed 
with painstaking care on thousands of cow- 
hides and on bricks in letters of gold, and 
was religiously guarded in the "Stronghold 
of Records," the treasuries, and temples. 
Very much of it was destroyed by the orders 
of Alexander, and the Mohammedans, after 
their conquest in the 7th Century a. d., 
burned all of the remainder that was found. 
The "Avesta" in its present form is, there- 
fore, a reconstruction from traditions and the 
memories of devotees. The portion called 
the Gathas bears internal evidence, how- 
ever, in phraseology and dialect, of being 
more intimately related to the original, and 
parts of it may be a survival, at least in 
form. The "Avesta" is divided into several 
books and treats of the life of Zarathustra 
(Zoroaster) and his teachings; precepts for 
sanctity and a religious life; history or 
cosmology; the law, moral and civil; the 
liturgy; and the book called the "Vendl- 



dad," the Law against Demons. This last 
book is of especial interest to physicians, 
as it relates almost entirely to disease. 
Chapters XX-XXII are strictly medical. 

The salient feature of the religion of 
Zoroaster is a dualism, two creators and 
two creations. Each creator has a following, 
creatures emanating from their principal, 
partaking of their respective characters, 
depositories of their respective powers and 
attributes, agents with varied functions 
to carry out the creator's will and to 
assist in waging the incessant warfare in 
which their principals are engaged. Ahura 
Mazda (Ormazd), above all others, the god 
of Light, the omniscient and wise creator 
of the universe and all good things, benefi- 
cent in the extreme, is supported by six 
Amesha Spentas, the "Immortal Holy 
Ones, " representing justice and piety, who 
form his court. Occupying an auxiliary place 
are the Yazatas, the "Venerable Ones," his 
angels who are, for the most part, ancient 
Aryan gods who have faded or have been 
demoted in favor of Zoroaster. To these 
are opposed in unremitting, malevolent, 
bitter conflict Angra Mainyu (Ahriman), 
the Enemy Spirit, the Principle of Evil, 
called "Druji," (Deception), ignorant and 
shortsighted, who created darkness, sin, 
disease, suffering, and evil of every kind. 
With him are six Arch-fiends, the antitheses 
of the Amesha Spentas, who are his com- 
manders and direct the activities of untold 
hordes of diabolical, evil spirits. These 
spirits of evil seek to overcome Ormazd, 
enslave him, and by every means in their 
power they endeavor to create confusion 
in all his good works, to destroy them. They 
introduce all evil into the world and attack 
man to his detriment and destruction. Man 



Medical Gods of Ancient Iran 



ever has a part in this struggle, aiding the 
one or opposing the other according to his 
moral attitude. Each work is an act of war- 
fare for the good or for the bad. This con- 
flict between the representatives of good and 
of evil continues without cessation through 
eons of time until eventually the world 
undergoes an ordeal, as of molten metal, 
by which it is purified. Thereafter evil will 
be eliminated and Ahura Mazda and good- 
ness will reign supreme. 

As is the religion so is the mythology of 
ancient Iran essentially dualistic and ma- 
terially influenced by its neighbors, of 
Mesopotamia on one side and more defi- 
nitely by the India on the other. Many 
of these myths are apparently of Aryan 
origin, and compared with those of the 
Vedas they show a marked similarity in 
theme and form, only personalities and 
details vary. For the most part they are 
truly Indo-Iranian. These myths all center 
about the theme of the struggles between 
the agencies of good and evil, mostly con- 
cerning creation and the valiant endeavors 
of Kings and ancient heroes to secure for 
the earth and for mankind the light, rain, 
and other blessings of Nature against the 
opposing forces of evil, of dragons and 
tyrants. These cosmic and terrestrial con- 
flicts are often in a storm-cloud amid the 
raging elements, on a mountain, or in a 
cavern with thunderbolt, wind, and fire as 
weapons for the confusion and destruction 
of the demons. 

The myth of the creation of the vegeta- 
ble kingdom, furnishing later all medici- 
nal plants, is of special interest. Ameretat 
(Long Life or Immortality), one of the 
Amesha Spentas, who had all plants under 
her guardianship, pounded them all very 
small and mixed them with water. The dog- 
star, Sirius, who was a good genius in Iran, 
made that water rain over the earth 
and plants sprang up, like hair on the 
head of man. Ten thousand grew to over- 
come ten thousand produced in caverns by 



evil spirits, and these ten became an 
hundred thousand. From these germs came 
the Tree of All Seeds which grew in the 
middle of the deep sea Vourukasha. Near 
to this tree, the Gaokerena (Ox-Horn) tree, 
the miraculous All Healer, developed. This 
tree was necessary to avert decrepitude 
and for the renovation of the Universe that 
immortality might follow. The Evil Spirit, 
Ahriman, set a lizard in the sea to injure 
the tree, but Ormazd, to keep that lizard 
away, created ten kar-fish which circle 
round it constantly, watch the lizard and 
guard the tree from harm. They are both 
fed spiritually and will watch each other 
until the whole Universe is renovated. 
The Gaokerena tree is the White Haeoma, 
a manifestation of the mystical haeoma 
plant, in its terrestrial form the yellow 
haeoma. The haeoma is the plant of Indo- 
Iranian sacrifice from which the famous 
drink, the haeoma, is made which gives 
strength and immortality to gods and men. 
This plant is named in the "Avesta" 
(Yasna IX-XI), and the preparation of the 
drink, with ritualistic ceremonies, is de- 
scribed. It is personified, made a divinity, 
and is invoked by prayers and hymns to 
drive disease and death away. 1 

Much of the "Avesta" is mythical and 
legendary. It praises and glorifies ancient 
Iranian kings and heroes. This portion is 
attributed to pre-Zoroastrian sages. Fir- 
dausi in his great Persian epic, "Shah- 
namah" or Book of Kings, written about 
a. d. 1025, relates many old traditions of 
Iran, and in historical form celebrates the 
mythical deeds of ancient kings and heroes, 
including those of the healing gods and 
heroes, Thrita, Thraetaona (called Faridun), 
and Airyaman. 

All disease was supposed to be governed 
by the same dualistic doctrine as religion 
and mythology. Being an attack or posses- 
sion by spirits of evil, the power of good 

1 Carnoy, "Mythology of All Nations," Vol. VI, 
p. 263. 



10 



Annals oj Medical History 



spirits must be evoked to secure relief. The 
universal conscience was the battle ground of 
Ormazd and Ahriman, and their followers. 
Sin and disease were on much the same 
plane. Sin was a spiritual and disease a 
physical malady. They were breaches of 
the moral or physical order resulting from 
pollution, visible or invisible, but substan- 
tial. This pollution must be removed by 
some rite or act which would effect a purifi- 
cation, and supernatural powers were called 
upon by invocations, hymns, and conjura- 
tion, often in conjunction with natural 
remedies administered with rites and cere- 
monies. 

Ahura Mazda declares that Angra 
Mainyu created 99,999 diseases, his daugh- 
ters. Disease was regarded as an entity, 
often personified by genii, and was given 
names. Zoroaster came to banish all noxious 
and evil spirits from the earth, and since 
they attacked man, causing disease and 
death, pending the time when evil shall be 
suppressed, he furnished man with abun- 
dant means in the "Avesta" by which he 
might free himself from their power. In 
the "Vendidad" he gave specific directions 
for their use. Two Amesha Spentas, Haur- 
vatat (Perfect Happiness or Health) and 
Ameretat (Immortality or Long Life) were 
assigned as special guardians of man, 
while Ahriman directed Tauru (Disease) 
and Zairi (Death) to oppose them as their 
malevolent, sworn enemies. The latter were 
actively sowing seeds of suffering, disease, 
and death. The former were provided with 
remedies to combat these ills, both the 
supernatural powers of Ahura Mazda, of 
which they were the repository, and the 
natural means revealed to Zoroaster by 
Ormazd, by tens, thousands, and tens of 
thousands. 

The cure is effected by the Amesha Spen- 
tas through the medium of the priests and 
physicians. The "Vendidad" contains the 
ritual for the guidance of the priests, direc- 
tions for the training of physicians and rules 



for their conduct, practice, and fees. The 
"Avesta" describes and lays stress upon 
three divisions of the healing art: kereta, the 
knife ;urvara, herbs; and, manthra, prayers, 
in the general sense of conjuration. Of these, 
conjuration is esteemed by far the most 
effective in bringing about the perfect cure, 
since by this means the soul as well as the 
body is purified and partakes of the cure. 
The Gathas contain many hymns and Zo- 
roastrian prayers used to free the sick from 
disease. By frequent repetition they gain 
force and effectiveness. Incantations, con- 
jurations containing the celestial or god- 
like Word, evocations and mystic formulae 
or magical spells were in common use. The 
formulae themselves were sometimes per- 
sonified and invoked, as: "Heal me, O 
Manthra Spenta, O Brilliant One!" Formu- 
las of conjuration were such as: "I conjure 
thee, death!" "I conjure thee, disease!" 
"I conjure thee, headache!" Natural means 
were also sought for purification and 
remedy for disease. For purification water 
was always preeminently good, but the 
urine of cattle was also considered highly 
efficacious. Sacrifices were made to propi- 
tiate and sway the will of supernatural 
beings and gain their favor. Fire was an 
averter of all evil and every impurity, an 
enemy of demons and disease. Magic spells 
consisting of hymns, prayers, incantations, 
written or spoken, were esteemed. Charms 
and amulets were also in vogue to ward off 
disease, the evil eye, the curse of an enemy, 
or to gain divine favor. The feather of the 
bird Varengana was used, and when rubbed 
on the body was considered very efficacious 
to keep back the curse of an enemy. The 
possession of a bone or feather of this bird 
was supposed to gain for the owner divine 
favor. Healing herbs were all derived from 
the miraculous Gaokerena tree, in the later 
"Avestas" called the Gokart tree or White 
Horn. It received its healing powers, which 
approached the magical, from Voku Manah, 
the son of Ahura Mazda. These were used 



Medical Gods of Ancient Iran 



ii 



by priests and physicians in connection 
with manthras, incantations, magic for- 
mulae and many superstitious ceremonies. 
The diseases of animals were governed by 
the same dualism as those of man, and 
similar measures were used for their cure. 

Magic and superstitious practices had a 
firm hold on the imagination of the people 
of Iran but were of less importance to them 
than to their neighbors of Mesopotamia. 
Though magic was discountenanced by the 
"Avesta" and at times held in check, rites 
and ceremonies essentially religious and 
elevating, symbolic of purification, piety, 
and virtue, easily degenerated into magic 
with an objective purely material. It thus 
crept back into the practices of the people 
and of the priesthood. Witches and sor- 
cerers, however, were abominations, not 
to be encouraged. The origin of medicine 
was supernatural and based upon ancient 
practices of the people. The "Vendldad" 
associated its origin with Thrita, calls 
Thrita the first physician, and ranks him as 
a god. Thraetaona and Airyaman are men- 
tioned as divine physicians and the hero 
Yima is credited with powers of healing. 
Although these gods and heroes were great 
benefactors of the human race and pos- 
sessed of marvelous skill in healing, their 
position as healers appears to have been 
somewhat theoretical and exalted. They 
brought the means of healing within the 
reach of man, but there is little evidence 
of a closer relation. Their names were used 
in prayers and hymns, but they did not 
develop cults, Haeoma and Mithra excepted. 

Of all the healing gods Zoroaster, the 
divine prophet, was first and foremost. He 
was the inspiration and author of the medical 
works of the "Avesta." Other healing gods 
and heroes of Iran were: Thrita, Thraetaona 
(Farldun), Airyaman, Haeoma, Yima, and 
Mithra. 

THIRTA 

Thrita (Thrita Athwya, or Vedic, Trai- 
tana or Trita Aptya), an Indo-Iranian 



deity, mentioned in the "Vendldad" (chap- 
ter XX) as the first physician, and asso- 
ciated with the origin of medicine. He was 
the first of the great, benevolent heroes who, 
before giving the Law, by means of his 
magic power caused all disease to cease. 
Thrita (meaning third) was the third priest 
of Haeoma, the Plant of Life, and one of 
the first to prepare from the plant the drink 
haeoma, ambrosia of the gods, which was 
deified as a remedy against disease, and 
which conferred immortality on both gods 
and men. In Iranian mythology Thrita 
had a secret abode in the sky and was 
known as the fire of heaven which blew 
upon the terrestrial fire and kept it alive. 
This fire he brought from heaven to earth. 
He was known, too, as an ancient hero, the 
slayer of a dragon the three-headed, six- 
eyed serpent Visvariipa. From Ahura Mazda 
he sought the source of all remedies, and 
myriads of healing plants sprang up 
about the Gaokerena tree. He possessed 
a knife with a golden point for surgical 
operations. He was the old wise one, crafty 
and brilliant, the first healer, the strong 
"who drove back sickness to sickness, death 
to death." In Firdausi's "Shah-namah" he 
is Abtin, the father of Farldun (Thraetaona), 
who is killed by the dragon tyrant Azhi 
Dahaka. Thrita was a deity of an early 
period. As a personality and healer he faded 
in favor of the great Persian hero, Farldun. 

THRAETAONA (fARIDUN) 

Thraetaona was an ancient Iranian deity, 
son of Thrita Athwya. In the "Vendldad" 
he is invoked against disease and prepares 
the haeoma. In a mighty struggle, aided by 
fire, he overcame the dragon tyrant Azhi 
Dahaka, an imp of deceit, created by Angra 
Mainyu, who had killed his father and had 
long sought Thraetaona's own life. This 
was the dragon with three jaws, three heads, 
and six eyes, from whose shoulders had 
sprung two serpents, the result of the kisses 
of Ahriman. After conquering the dragon 
Thraetaona fettered him with chains in a 



12 



Annals oj Medical History 



cavern on Mount Damavand for a thousand 
years and took possession of his palace, 
reigning peacefully for five hundred years. 
Firdausi, in his Shah-namah, under the 
name of Farldiin, relates this heroic conflict. 
Thraetaona is credited with being the in- 
ventor of medicine, a great healer and a 
master magician. Aside from this, tradition 
says little of him. In modern Iran the 
ancient Thrita and Thraetaona become 
fused in the national hero Faridun. By this 
name also he is known as an averter of 
disease, of all evil and bad influences. His 
name appears in the medico-magical for- 
mulae and still plays an important part in 
the magic of the Parsees. 

AIRYAMAN (ARYAMAN) 

Airyaman, an Indo-Iranian deity, is cele- 
brated in the " Avesta" as a benevolent god, 
a healer par excellence. He is apparently 
the personification of prayer, and in this 
capacity was a most effective healer, since 
by prayer or conjuration the soul shared 
in the purification and a perfect cure re- 
sulted. Ahura Mazda calls upon him for 
cooperation, in expelling disease and death. 
He performed the rite of purification so 
effectively with his magic formulae and 
prayers of praise that he caused 99,999 
diseases to cease. He is constantly called 
the "tree desire." 2 Later he becomes the 
tutelary genius of physicians to whom he 
gives miraculous powers of healing. He is 
mentioned in the Vedas, and although his 
role is not defined, is sometimes included 
in the Indian triad, Varuna, Mitra, and 
Airyaman. 

YIMA 

Yima (Vedic, Yama), a very ancient 
Indo-Iranian hero, mentioned in the 
"Avesta" as The Brilliant, the son of 
Vlvanghvant, who first offered the haeoma 
to Ahura Mazda. He was a spiritual and 
material educator of man, the hero of an 
extensive myth of the early development 
of the world. He is celebrated by Firdausi, 

2 Darmsteter, S. B. E., p. 219. 



in his Shah-namah, under the name of 
Jamshid. In the golden age of Yima he was 
chief of a remote realm in which there was 
neither cold nor suffering. He subjugated 
the daevas and all their imps. Here he reigned 
for from 700 to 1000 years, and for 300 
years of this time man never looked on 
death. The "Vendidad" describes him as 
taking the path of the sun to open the earth 
to mankind, and he is called the Lord of 
Settlers. The life of Yima and that of the 
dragon, Azhi Dahaka, appear to run parallel. 
Azhi Dahaka, the storm-cloud monster, 
sought to injure the settlers of Yima, and 
they engaged in a struggle. Yima had 
committed some sin. The Gathas state 
that he had fed his subjects with forbidden 
food to make them immortal. Firdausi says 
that, "his mind began to dwell, on words 
of falsehood and of untruth." Because 
Yima "diverged from the path of justice" 
he lost his glory and his kingdom, and 
was finally put to death by the dragon, who 
then extended his devilish power over 
the Aryan world. Later Faridun overcame 
Azhi Dahaka and succeeded to the kingdom. 
Jamshid is also glorified as being a con- 
structor and the originator of castes. Fir- 
dausi ascribes to him medical knowledge 
and skill, and Jamshid is said to have 
known: 

"Next to Ieechcraft and the healing of 

the sick, 
The means of health, the course of 

maladies." 

HAEOMA 

Haeoma (Vedic, Soma), an Iranian deity 
from primeval times . . . the mystical 
White Haeoma, identified with Gaokerena 
or Gokart tree, may or may not have been 
the same as the haeoma plant of the later 
"Avesta." It is mentioned in the book of 
the "Avesta" called the Yasna and from 
it was made the sacred drink, the Haeoma, 
which gave strength and immortality to 
gods and men. This drink was prepared by 



Medical Gods of Ancient Iran 



i3 



the priests according to the Horn Yasht 3 
with ritual prayers and ceremonies by press- 
ing the juice from the twigs of the plant, 
filtering and mixing it with milk, honey, or 
other liquid. It was exhilarating, gave a sense 
of power and ability, and produced intoxica- 
tion. It was at one time the subject of or- 
giastic sacrifice and was banished by the 
Gathas. In a later time it reappeared, but 
without these objectionable features. Viv- 
anghvant first offered the drink to Ahura 
Mazda, and it was from his son Voku Manah 
that it received its healing power. Both the 
drink and the plant were personified and 
worshiped as divinities and invoked to 
drive away disease and death. A drop of 
Haeoma was placed on the lips of the dying 
faithful. It grew in inaccessible places on the 
mountains and was brought to earth by 
divine birds. It also had the power of 
slaying demons, and of bestowing spiritual 
light and blessings upon man. 

MITHRA 

Mithra (Vedic, Mitra), an Indo-Iranian 
god of great antiquity, and whether of 
Aryan, Iranian or Vedic origin cannot be 
determined with any certainty. He was 
intimately associated with the Vedic god 
Varuna. They represented moral light, law 
and order. They were the "Guardians of 
Holy Order"; they hated, drove away and 
punished falsehood. The eye of Mitra and 
Varuna was the sun. Mitra had the occult 
power by which the dawn appeared, the 
sun crossed the sky, the clouds obscured it 
and rain fell upon the earth. Apart from 
Varuna, the Vedic Mitra was a faint 
personality. 4 In the Iranian myth, Mithra 
had a definite solar nature. At first he was 
the god of immaterial light and later, by 
analogy, of the sun. He was also the god 
of faithful contracts. It is said that Mithra 
once measured his strength with the sun, 

3 Yasna IX-XI. 

* Keith, "Mythology of All Nations," Vol. VI, 
p. 20. 



with whom he later made a compact of 
friendship, and these allies thereafter sup- 
ported each other in all events. He was the 
logical son of Ahura Mazda and was the 
most important Yazata. Among the Iran- 
ians he was the god of the plighted word, 
the protector of justice, the god who gave 
victory in battles against the foes of Iran, 
the defender of the worshipers of truth and 
righteousness. 5 

The cult of Mithra was early identified 
with occultism and mystic ceremonies. 
These ceremonies had many points in com- 
mon with those of the Christians; baptism, 
communion with bread, and wine; ointments 
of honey, etc., which resembled the oint- 
ment of confirmation. The sacraments were 
considered beneficial for the cure of the 
body as well as for the sanctification of the 
soul. Bread, wine, water of baptism, oint- 
ments were regarded as mystic remedies, 
and all the medicine of the god Mithra 
was purely mystic. In the baptism of blood, 
the Taurobole, the patient was led beneath 
open planks and the blood of a bull above 
filtered through and fell, in a mystic sense, 
like a beneficent rain. The cure consisted not 
in the blood, but in the symbol, the passion 
of Mithra. The bull, representing the god, 
shed his blood for the faithful sick; an 
instance of divine abnegation in a primitive 
religion. The cult of Mithra, popular and 
powerful in Iran, spread rapidly to Greece 
and over the Roman Empire, carrying with 
it the occultism and mysteries which had 
characterized it in Persia. The Romans saw 
Mithra's astrologers passing whole nights 
on the tops of their towers, and his magicians 
practiced their mysteries on the slopes of 
the Aventine and on the banks of the 
Tiber. 6 The cult encountered bitter hatred 
and the opposition of all Christians, and 
the struggle continued in the more remote 
quarters into the Middle Ages. 

6 Carnoy, Ibid. Vol. VI, p. 287. 

6 Bruzon, "La Medecine et Ies Religions," p. 137. 



THE "PULMOTOR" OF THE EIGHTEENTH CENTURY 



By J. COLLINS WARREN, M.D. 



BOSTON, MASS. 



IN the just published history of the 
Humane Society of the Common- 
wealth of Massachusetts, one of the 
oldest charitable institutions in the 
United States, is an account of an apparatus 
designed for the purpose of the inflation of 
the intestinal canal by tobacco smoke as 
a means of resuscitation of the apparently 
drowned. To the public, and even to the 
medical practitioner of to-day, the story of 
such a mode of treatment would seem to be 
almost beyond the bounds of credulity. 
From what mythical traditions of the past 
could such a device have been derived, or 
what could possibly be the physiological 
action of such a remedy are questions which 
naturally suggest themselves. 

Any student of the medical literature 
of the seventeenth and eighteenth centuries 
is familiar with the prominence given to the 
clyster in the tripod of medical therapeu- 
tics. Venesection, emetics and the clyster 
were the three most potent means of reach- 
ing the tissues and fluids of the body in a 
morbid state and thus clearing out what 
were then called the "peccant humors." 

The importance attached to the last of 
this trinity is shown at an early date, for we 
find that Scultetus, in his work on surgery 
( 1 671), considers the apparatus devised for 
this purpose worthy of a minute description 
and a full-page illustration. 

It was at about this period that the 
writings of Moliere served to accentuate 
this therapeutic custom, or at all events 
to record the prominent place which it held 
in the treatment of disease. Be that as it 
may, the clyster held its own conspicuously 
among the heroic measures inflicted on 
suffering humanity for the better part of 
two centuries. 
Among the earliest records 1 we have of the 
1 The therapeutic value of tobacco was thus 



remedial qualities of tobacco smoke is that 
quoted by Pia from the history of a Journey 
to America, in which it is stated that the 
savages ("d'Acadie") have a singular 
method of resuscitating the apparently 
drowned who have swallowed a great deal 
of water. They fill an animal's bladder, or a 
large segment of intestine tied at one end, 
with tobacco smoke and attach it to a tube 




Fig. 1 shows the fumigator; a machine for injecting the 
smoke by way of clyster in those desperate cases which re- 
quire the application of this remedy. It consists of a pair of 
bellows to the muzzle of which is fitted a metal box a 
provided with a ring, in the middle of which it may be un- 
screwed and again closed, after being filled with tobacco and 
set on fire. The pipe c of the flexible tube 6 is intro- 
duced into the fundament and thus by means of the bellows 
d the smoke is forced into the rectum. 



14 



The Pulmotor of the Eighteenth Century 



15 



which is then introduced into the fundament 
of the patient. By this means the smoke is 
injected until the abdomen becomes dis- 
tended. They then hang the patient by the 
feet to the branch of a tree and the smoke 
is thus enabled by its pressure to force the 
water, which the patient has swallowed, 
out of his mouth. 

In France Reaumur (1 683-1 757), who, 
by the way, is not generally recognized as 
having been a member of the medical 
profession, was the first to introduce the 
use of tobacco smoke in this way. He 
suggested that this could be accomplished 
by breaking off the stem of a pipe and 
blowing the smoke through it. It is duly 
recorded that one of his colleagues in the 
Academy testified to the proper and satis- 
factory effect of this remedy. His article was 
published in 1740. Incidentally it may be 
mentioned that he recommended rolling the 
patient to and fro in an open barrel, a device 
which owed its usefulness to the effect it 
had in producing artificial contraction and 
expansion of the thoracic cavity, although 
the restoration of this function was not 
evidently recognized as an important feature 
at that time. 

In Holland the literature on this subject 
seemed to have been more abundant than 
in other countries, as might naturally be 
supposed from its geographical character. 
The reports of the Society of Amsterdam 
are filled with many accounts of the use of 
described by Lobelius in 1576. Speaking of its use 
by the inhabitants of the West Indies he says, 
. . . "For you see many sailors who have returned 
from that country who carry little funnels made of a 
coiled palm leaf, or of reeds, into one end of which 
are placed curled, broken up and dried leaves of this 
(nicotiana) plant. They set light to it, and drawing 
it into their mouths as much as they can, they suck 
in the smoke by inhalation. They are thereby 
enabled to endure hunger and thirst to maintain the 
strength and to exhilarate their spirits. They declare 
that it soothes the brain with a pleasant form of 
intoxication and it certainly gives rise to an incredible 
quantity of spittle." The Quarterly Review, July 1913, 
p. 139, London. 



this remedy. Gobius, a distinguished Dutch 
surgeon (in his book "Adversaria Varii 
Argumenti"), employed tobacco smoke in 
this way for constipation, colic, and strangu- 
lated hernia. It is stated that he practiced 
in a country where the insufflation treat- 
ment had been used many hundred times. 
De Haen had used it two hundred times and 
for more than one hour at a time, the smoke 
being introduced with much force and in 
large quantities, both in experiments on 
animals and a variety of human ailments. 
Laurence Heister in his "Institutiones Chi- 
rurgicae," Amsterdam, 1750, in a chapter 
on Clysters, refers to the use of fumigation 
for incarcerated hernia, and gives a diagram 
of the apparatus by which tobacco smoke 
can be blown by the mouth of a surgeon 
into the intestine, the smoke, according to 
the author, acting as a stimulus in the 
intestine and causing the strangulated loop 
not only to shrink in size, but to retract 
itself into the abdominal cavity. (Fig 2.) 

Dr. Ludwig Knapp (1908) in a modern 
rendering of Cangiamila's work on Theology 
and Midwifery, 1754, mentions among the 
remedies this ancient author laid down 
for the resuscitation of new-born infants 
apparently dead, the use of clysters of 
tobacco smoke "to establish the peristaltic 
action of the intestines and thus arouse 
through cooperation of the diaphragm the 
action of the heart and lungs." If these are 
the words of the author, and not the 
translator's, we have here the first indication 
of the recognition of a physiological purpose 
in the use of this remedy. 

Christopher Keil, in his handbook on 
Surgery, 1747, Leipsic, describes the use of 
clysters and recommends long flexible tub- 
ing for the purpose. In a frontispiece in this 
work an illustration is given of such an 
apparatus, by which an individual is able 
to administer to himself rectal insufflation. 

(Fig. 3-) 

In the latter half of the eighteenth 
century (1772) we find an organization was 



i6 



Annals oj Medical History 



established in Paris for the purpose of 
rendering aid to the apparently drowned. 
An early report of this institution 2 de- 
scribes a box containing bottles filled with 
various restoratives and a "machine fumi- 
gatoire" 3 with a bellows and a cannula. In 
the introduction to the report, it is stated 
that, at this period, in France, the cities 
of Paris, Lyons, Tours, Lille, LaRochelle, 
and elsewhere, have founded private organ- 



istry, a notice being duly circulated among 
the provincial officers. Paragraph III of the 
directions specifies forcible insufflation into 
the rectum of tobacco smoke, either by a 
pipe stem, or through the leather sheath 
of a knife cut open at the point, or by an 
ordinary bellows. 

An extract from an Admiralty Report of 
the town of Dunkirk, 1777, refers to the 
fumigating machine kept by the town 




Fig. 2. 



izations for the same purpose. The meth- 
ods generally employed by these various 
organizations towards the end of the 
eighteenth century were recommended 
officially (just as artificial respiration is 
to-day) by the Maurepas (1701-1781) Min- 

2 Detail des succes de I'establissment que la ville 
de Paris a fait en faveur des personnes noyees, 1775. 

3 "A fumigation machine is kept at every station 
house. The method of using it is as follows: — Half an 
ounce of smoking tobacco is placed in the box of 



authorities for this purpose. Incidentally 
it may be mentioned that one of the rules 
laid down by this report was to forbid the 
rolling of a body in a cask or to hold the 
body up by the feet. 

The Royal American Magazine, February 

the machine and is slightly moistened. The bellows 
are then attached and force the smoke through a 
long pipe; three quarters of an hour should be 
employed in administering the half ounce of tobacco. 
The bellows should be blown gently." 



The Pulmotor of the Eighteenth Century 



17 



1774, gives Dr. Tissot's method of restora- 
tion of the apparently drowned. Here it is 
stated that in addition to blowing the warm 
breath into the patient's lungs, tobacco 
smoke may be introduced not only into the 
fundament, but into the lungs as well. After 
tobacco has been lighted in the bowl of a 
pipe, the bowl should be wrapped in a 
paper in which several holes are pricked 
and through these holes force the breath 
strongly. It is also recommended by this 
author that if a surgeon is present the 
jugular vein should be opened and about 
twelve ounces of blood taken. 

It may be well to give here examples of 
the methods employed at this period in 
two cases. 

Rene H., 25 years old, while bathing, was 
rescued from the water three-quarters of an 
hour after being submerged. He was un- 
conscious, without voluntary movements 
and pulseless, and supposed to be dead. 
Taken to the Guard House the soldiers 
treated him by insufflation of air into the 
mouth, rectal fumigations with tobacco, 
friction of the skin, and application of 
ammonia to the nostrils, a treatment which 
extended over two hours, when signs of life 
began to appear, the eyelids moving and 
the pulse being felt, etc., and finally move- 
ments of the body and cries. He was then 
carried to a house nearby where warmth 
was applied. Here he was bled from the arm, 
instead of the jugular vein, owing to his 
resistance. Tobacco fumigation produced 
abundant evacuation of the bowels and an 
emetic brought up a large amount of salad 
and other food. He was made to swallow 
brandy, which served the purpose of an 
"anti putrid cordial," and revived him. 
His comrades next took him to their inn 
and carried out further ministrations advised 
by the surgeon who bled him. After receiving 
two purgings, he reported on the fourth 
day at the City Hall to express his grateful 
acknowledgments, stating that he had had 
no recollection of what had happened to him. 



The following case is stated to show that 
rectal insufflation can be employed, even 
when the necessary machinery is not at 
hand. 

A rescued woman's husband, who thought 
his wife dead, was told by a passing soldier 
smoking his pipe to dry his tears, that his 
wife would soon be revived. Then giving 
the pipe to the husband, he instructed him 
how to introduce the stem into the anus, 
then placing his mouth, covered with 
perforated paper, to the bowl of the pipe, to 
blow with all of his force. At the fifth 
insufflation of smoke a loud rumbling was 
heard and the patient expelled water from 
the mouth and a moment later regained 
consciousness. 

But this method, even at this time, was 
not without its critics, for M. Portal, 
Professor of Medicine at the Royal College 
of France, claimed that the insufflation 
impeded the circulation of the vessels of 
the viscera in the abdomen and thorax 
and thus acted injuriously. Pia, however, 
refers in reply to this objection to the 
quotation of Heister, which we have already 
mentioned above, to the effect that tobacco 
smoke appears to irritate the intestine and 
cause a diminution of its caliber. 

In London we find John Aiken (1775), 
using the rectal insufflation of tobacco smoke 
and preventing the over-heating of the tube 
by wrapping cloths wet in cold water 
around it. The use of this remedy was 
recommended by him as a "stimulant to 
arouse the vital motions." 

CuIIen, Edinburgh, 1784, in a letter to 
Lord Cathcart, says, "with regard to the 
stimulants, I must conclude with observing 
that when a body has laid but a short time 
in the water and that therefore its heat and 
irritability are but little impaired, the 
application of stimulants alone has often 
been found to be effectual for recovery. 
But, on the contrary, when the body has 
Iain a long time in the water and the heat 
of it is very much extinguished, the applica- 



Annals oj Medical History 



tion of any other stimulants than that of 
tobacco smoke to the intestines can be of 
very little service — and the application of 
others ought never to interfere with the 
measures of recovering heat and the motion 
of respiration." 

Goodwyn, (1788) refers to the application 
of different substances to the skin, the 
stomach, the intestines, the parts of genera- 
tion, the nose, the fauces, the extremities of 
the fingers by Jacob Gummer as based on a 
mistaken opinion of the principal seat of 
life. 

But Kite, 1795, in experiments on animals 
rendered insensible by submersion, gives as 
his opinion, under the head of other 
remedies, that the "principal of these are 
electricity, particular stimuli adapted to the 
different organs of sense and irritating 
medicines thrown into the stomach and 
intestines." Here, for the first time, we find 
powerful stimuli like that of electricity used 
for arousing vital action. But while the 
surface of the body thus has the benefit of 
the new agencies, the interior surfaces are 
not neglected. Our old friend "rectal in- 
sufflation" is still employed with a view to 
local stimulation. 

But a definite reaction had already set 
in, for we find that Edward Coleman, 
London, in 1791, speaks in no uncertain 
terms as follows: "As tobacco smoke thrown 
up the rectum in the form of smoke was one 
of the first remedies employed in suspended 
respiration, and as we see, to our regret, that 
it is still too frequently made use of, we shall 
endeavor by a few animadversions on its 
effects to proscribe its continuance. . . . 
The history of medical errors scarce affords 
a more blind and obstinate prejudice than 
that which still induces us to adopt a 
mode of practice so obviously destructive. 
For smoke and fluids of all kinds, when 
given in large quantities, will distend the 
intestines, the result of which will be that 
their mechanical effect in preventing the 
easy descent of the diaphragm will neces- 



sarily be productive of mischief." In con- 
cluding this statement, he speaks next of 
the sympathy between the heart and the 
stomach as being greater than between the 
heart and intestines. Here evidently was a 
pioneer in modern therapeusis! 

In Dr. Willich's Domestic Encyclopedia, 
London, 1802, is given the list of articles 
contained in a box devised by Kite and 
further amplified by Mr. Redlich of 
Hamburgh, among which is to be found 
the machine for injecting the smoke of to- 
bacco. Fig. 4. Willich shows clearly in his 
article that inflation of the lungs is one of 
the means of restoring life. "Stimulating 
clysters consisting of warm water and com- 
mon salt or a strong solution of tartar 
emetic, or six ounces of brandy should be 
speedily administered. We do not consider, 
he says, injection of the smoke of tobacco, 
or even clysters of that narcotic plant in all 
instances safe and proper." 4 

The final touch may have been said to 
have been placed on this mode of practice 
by Daniel Legare (1805) who, in an 
inaugural dissertation, on graduating from 
the University of Pennsylvania, presented 
as his graduation thesis experiments upon 
animals with the rectal insufflation of 
tobacco. After the insufflation the abdomen 
was opened and the changes in the cir- 
culation carefully observed in a series of 
cases. He found an increase in the mesenteric 
arterial circulation, but a diminution of the 
peristaltic action of the intestines. He 
concluded that this method was of no value 
as a means of resuscitation. 

Although it is often difficult to repress a 
smile at some of the medical theories of a 
bygone period, it is well to pause in this 
instance before passing final judgment and 
to ask ourselves whether there may not 
have been after all some well founded obser- 
vations which served to implant a thera- 

4 See "History of the Humane Society of the 
Commonwealth of Massachusetts," by M. A. De 
Wolfe Howe, p. 18. 



The Pulmotor of the Eighteenth Century 



19 



peutic measure so firmly in the traditions of 
medical practice. 

The ancients were wont to regard the 
rectum as the ultimum moriens. Here there 
was supposed to exist one of the principal 
seats of life. Its outlet, an extremely sen- 
sitive region, is abundantly supplied with 
nerves and blood vessels and easily accessi- 
ble to restorative measures. This faith in 



ailments. Moreover, the levator ani muscle, 
being composed of a powerful enveloping 
mass of muscular fiber and bearing an 
intimate relationship to the lower intestinal 
canal, has been classed by more than one 
physiologist of the past as one of the muscles 
of respiration. It is at least one of the 
groups of muscle which exert an antagonistic 
action to that king of respiratory muscles, 




Fig. 3. 

certain sensitive surfaces as the principal 
seat of life referred to by Gummer fore- 
shadowed only what has quite recently 
taken the form of a modern cult known as 
"orificial surgery," the dilatation of these 
highly sensitized orifices being supposed to 
exert a strong curative influence in many 




Fig. 4. 

This illustration is reproduced from Willich's Domestic 
Encyclopedia (London, 1802). Figs. 1, 3 and 4 represent, 
respectively, bellows to inflate and extract air from the lungs; 
a stretcher of wickerwork that water may easily run off, and 
a warming machine of block tin or copper with double walls 
to contain hot water. 



the diaphragm. The well-known case of 
I'homme a I'anus musicale was a striking 
illustration of the coordinating power of 
these two great muscular groups. May it not 



20 



Annals of Medical History 



have been possible that a powerful stimulus 
given to the rectal group may have been 
transmitted by reflex action in certain 
cases to the thoracic group? Pressure and 
heat applied to the abdominal region, even 
from within, may have in times of great 
stress helped to compress the thorax and to 
awaken the latent forces in the diaphragm. 
Be that as it may, it should not be for- 
gotten that the fullness of time often leads 
to a new perspective. Who can say that the 



modern pulmotor, or the particular method 
of resuscitation based on claims of accurate 
laboratory research, may not eventually take 
their place among the vagaries of the past? 
At all events, it is perhaps just as well 
that practitioners of medicine to-day should 
look upon this quaint old custom, which 
died so hard, with an indulgent eye and, 
reading between the lines, draw from it 
with becoming humility a moral on the 
mutability of medical affairs. 



COMPIEGNE 



At a confluence of rivers lies the town of Compiegne, 

At the wedding of the waters, River Oise with River Aisne. 

And across the verdant valley lie everlasting hills 

With their sunny slopes and gardens and villages and mills. 

Horizon-wide the forest encompasses the town, 

And in her spacious bosom the city nestles down 

To dream of former glories, e'er this devastating war 

Changed all the gracious things that were for grievous things that are. 

A thousand years in passing are but a watch at night; 
A thousand recollections of kings in armor bright; 
A thousand dreams come shimmering across a bending bow 
For the true interpretation that only dreams can know. 

And on a misty evening, when trunks of ancient trees 
Are swaying indistinctly in the intermittent breeze, 
I seem to sense the phantoms that crowd the pleasant ways 
In restless reminiscence of the long forgotten days. 

Carleton B. McCulloch, M.D. 
June, 1918. 



THE BIRTHPLACE OF THE HUNTERS 



By FIELDING H. GARRISON, M.D. 

WASHINGTON, D.C. 



THROUGH the courtesy of Colonel 
C. C McCuIIoch, Librarian of 
the Surgeon General's Office, it 
is our privilege to reproduce an 
interesting photograph of the old house at 
Long Calderwood, where John and William 
Hunter were born. The inscription on the 
back of the picture is in the handwriting 
of the late Dr. John S. Billings and reads : 
"Long Calderwood, the birthplace of John 



showing that the laird himself tilled the 
soil." Long Calderwood is in the south- 
western county of Lanarkshire, a part of 
the country which had been much fought 
over by the ancient Romans, and in later 
wars. Hereabouts the brave Wallace fought 
and bled; in this county, Mary, Queen 
of Scots, was defeated at the battle of Lang- 
side in 1568; Claver house was defeated by 
the Covenanters at Drumclog (1679) an d 




Fig. i.I Long Calderwood 



and William Hunter. Rec'd from Dr. An- 
drew Fergus of Glasgow, Feb. 14, 1885, 
J. S. Billings." 

Long Calderwood, on a small estate, 
seven miles from Glasgow, is described by 
Mather, in his biography of the two 
Hunters, as "A good stone house of two 
stories, situated near the road leading 
from East Kilbride to Blantyre, quite like 
the residence of the laird of the small 
estate. The house has the appearance of 
having been all along the abode of 'bein' 
substantial people, and has behind it a fine 
large court, enclosed by farm buildings, 



himself defeated them at Bothwell Brig 
(1679). I n th e eighteenth century, the 
historic shire was unusually productive of 
medical talent. CuIIen, Smellie, Matthew 
Baillie, as Avell as the two Hunters, were 
all of them Lanarkshire men. The Lanark 
branch of the Hunters was an offshoot of 
the Hunters of Hunterston (Ayrshire), an 
old Norman family of the thirteenth cen- 
tury. As it stands, this stern, gray house, 
over two centuries old, is representative 
and typical of the old granite Scotch — 
their intense love of plainness and simplicity 
in externalities, their dislike of the showy 



22 



Annals oj Medical History 



and the pretentious. And yet there is about 
the old house just that suggestion of the 
romantic in achievement which, as William 
Ernest Henley said, has given Scotland her 
unique place in history. The grim, bleak, 
dour sky, which furnishes the bath of 
atmosphere, or the lack of it, suggests the 
"gray Galloway land" nearby, where the 
whaups cry as of old over the graves of the 
martyrs of religion : 

"Blows the wind to-day, and the sun and 
rain are flying, 



Blows the wind on the moors to-day and 

now 
Where about the graves of the martyrs 

the whaups are crying 
My heart remembers how. 

Gray tombs of the dead in desert places, 
Standing stones on the vacant wine-red 
moor, 
Hills of sheep and the homes of the silent 
vanished races, 
And winds austere and pure." 



CLINICAL PICTURES FROM HIPPOCRATES 



The greatest and most dangerous disease, 
and one that proved fatal to the greatest 
number, was consumption. With many 
persons it commenced during the winter, 
and of these some were confined to bed, and 
others bore up on foot. Most of those who 
were confined to bed died early in the 
spring; of the others the cough left not a 
single person, but it became milder through 
the summer; during the autumn all these 
were confined to bed, and many of them 
died, but in the greater number of cases the 
disease was long protracted. The onset was 
usually sudden, with frequent rigors, often 
continual and acute fevers; unseasonable, 
copious, and cold sweats throughout; great 
coldness, from which they had great dif- 
ficulty in being restored to heat; the bowels 
variously constipated and again immedi- 
ately loosened, especially toward the end of 



each attack; . . . coughs frequent through- 
out, sputa copious, congested and liquid, 
but not brought up with much pain. . . . 
By far the greatest mischief attending these 
and the other complaints was the aversion 
to food, as has been described. For neither 
had they any relish for drink along with 
their food, but continued without thirst. 
There was heaviness of the body, disposition 
to coma, in most cases swelling, which ended 
in dropsy; they had rigors, and were de- 
lirious towards death. 

The habit of body peculiarly subject to 
phthisical complaints was the smooth, the 
whitish, that resembling the lentil; the 
hectic, the blue-eyed, the lymphatic, and 
that with the scapulse having the appearance 
of wings. 

Hippocrates. "Epidemics." Book III, 
i3» J 4- 



TWO CHAPTERS IN THE HISTORY OF LARYNGOLOGY 

AND RHINOLOGY 1 

By JAMES J. WALSH, M.D., Ph.D., Sc.D. 

NEW YORK CITY 



THE writings and addresses of Dr. 
D. Bryson Delavan have been 
especially important in calling at- 
tention to the fact that the spe- 
cial chapter in the history of medicine of 
which physicians in New York have most 
right to be proud is that of laryngology and 
rhinology. He has shown that members 
of the medical profession in New York, 
during the latter half of the nine- 
teenth century, revolutionized the treat- 
ment of diseases of the nose and throat and 
were pioneers, not only for America, but for 
the medical and surgical world in this great 
modern development of medical and surgi- 
cal practice. The story of the striking evo- 
lution of these specialties in New York, 
beginning with Horace Green and not yet 
ended, for there are men still alive who 
have done thoroughly original work and 
very precious work in this department, is 
of the greatest interest and significance. 
Unfortunately, it is not known as well as 
it should be even by those most deeply 
interested in the practice of the specialties 
in question, but then until very recently 
physicians generally have not been inter- 
ested in the history of their great profes- 
sion, though they are waking up now and 
are learning how many practical, valuable 
hints might be secured from the history of 
medicine. 

Some of the details of this chapter of 
surgery in New York must be repeated for 
their significance to be appreciated. In 1817 
Dr. Cheesman, the worthy head of a dis- 
tinguished series of generations in New 



York medicine, published an article upon 
"Growths and Tumors of the Throat," 
which represented an appropriate begin- 
ning of serious interest in throat diseases. 
In the late thirties Dr. Horace Green, here 
in New York, began his epoch-making 
work in the direct treatment of affections 
of the larynx and trachea. The surest sign 
that his work was a real advance and far 
ahead of anything that had been done 
before is the fact that it met with decided 
opposition. I have often quoted Dean Swift 
with regard to such incidents of opposition 
to real advance in science which, until we 
knew history properly, used almost to be 
attributed to religious intolerance or big- 
otry of some kind related to religion. The 
incidents in question are practically always 
due to the conservative tendencies of man- 
kind. These make them resent important 
advances, when they are really new, though 
they are so prone to welcome novelties of 
no significance. Dean Swift said, in his own 
bitter frame of mind, of course, but still 
with an approach to truth that has made 
the expression one of the oft-quoted pas- 
sages from his works, "When a true genius 
appears in the world you may know him by 
this sign — that all the asses are in confed- 
eracy against him." Dr. Green had to strug- 
gle on in spite of opposition, which seems 
lamentable to us as we look back, though 
our generation has and doubtless will react 
similarly to other genuine advances. 

We in New York had another example of 
the truth of Dean Swift's expression when 
sensitive Dr. O'Dwyer found himself alone, 



1 This article is an extension of some remarks at the meeting of the Section on Historical Medicine of 
the New York Academy of Medicine, when "A Description of a Tonsilectomy Done Seven Centuries 
Ago" was presented. 

23 



24 



Annals oj Medical History 



with practically all the world in opposition 
to him, on the occasion of his presentation 
of the subject of the intubation of the 
larynx for diphtheria and other stenotic af- 
fections. As a matter of fact Dr. Horace 
Green was laying the foundation on which 
O'Dwyer was to build, demonstrating clearly 
that the larynx would tolerate foreign bod- 
ies to a much greater degree than had 
been thought possible. Both of them suf- 
fered, but only as did many another dis- 
coverer in the history of medicine and sci- 
ence from the ultraconservatism of their 
contemporaries, and it is well for us to re- 
member that such incidents are not me- 
diaeval nor distant in history, but occur in 
our own time. 

Horace Green's work bore fruit, however, 
in .spite of opposition, and by his writings 
he laid the foundation of the great specialty. 
His contemporary, Dr. Gurdon Buck, by 
his studies of conditions of the larynx and 
especially his epoch-making paper upon 
"Edematous Laryngitis and Its Treatment 
by Scarification," made an important ad- 
vance for all the world. Dr. Ernest Krack- 
owizer received a laryngoscope from Vienna 
in 1858 and demonstrated its value. Dr. 
Horace Green predicted that the instrument 
would work a revolution in laryngology, as 
it did. Already an American, Dr. Ephraim 
Cutter, who later practiced in New York, 
had devised a laryngoscope and the devel- 
opment of the specialty was assured. As 
early as 1873 the f irst Iaryngological society 
ever organized was established in New 
York. In 1878 the American Laryngological 
Society was organized in the city of Buffalo, 
the main influence in it being New Yorkers. 
In 1 87 1 the first clinic devoted exclusively 
to the diseases of the nose and throat was 
established by Dr. Louis Elsberg. Dr. 
George M. Lefferts, beginning May 1875, 
collected a bibliography of laryngology 
until 1880, when a special journal known as 
the Archives oj Laryngology, the first of its 
kind in the world, was founded. 



In the eighties Dr. Joseph O'Dwyer 
completed the series of experiments on 
which his method of intubation is founded, 
and added one of the world's great prac- 
tical discoveries to this specialty. Dr. 
O'Dwyer's work was really that of a genius, 
and he must ever be considered as one of 
the great men of American medicine. 

In the meantime had come the inventions 
of the Bosworth saw for bone and nasal 
obstructions and of the Jarvis snare for 
the removal of enlarged turbinates, and the 
work of Dr. Roe, of Rochester, in the sub- 
mucous resection and correction of deformed 
septum and other nasal obstructions or 
deviations. The nasal trephine was invented 
by Dr. James H. Goodwillie, and a whole 
series of valuable instruments, modifications 
of preceding less available instruments, were 
designed. Dr. Rufus P. Lincoln devised the 
method for the removal of retropharyngeal 
fibromata through the natural passages in- 
stead of by an external wound, which would 
have required extensive, dangerous dis- 
section, involving serious bleeding and many 
risks. In 1886 Dr. Thomas French, in Brook- 
lyn, devised a special camera for photo- 
graphing the larynx, a purpose which had 
been attempted often enough before, but 
without any success. In 1897 Dr. Bryson 
Delavan of New York recommended, in- 
stead of cautery, submucous puncture of 
an intumescent inferior turbinate by 
means of a cataract knife, some of the 
vessels being divided and becoming oblit- 
erated by the resultant cicatricial tissue. 
He has also carried out numerous investi- 
gations, among them the treatment of 
atrophic rhinitis by applications of the 
galvanic current and the value of the x-ray 
in the treatment of malignant tumors of 
the larynx. Dr. Morris Asch of New 
York finally developed and perfected 
the means of securing correction of certain 
deformities of the nasal septum which had 
proved serious obstacles to any improve- 
ment in a number of cases where interfer- 



History of Laryngology and Rhinology 



2 5 



ence with natural nasal breathing was one 
of the most important factors in the case. 1 

Surely that long list of pioneers and their 
discoveries in this specialty, comparatively 
limited, yet so important for health, makes 
it very clear that New York well deserves 
a place of high honor in the history of med- 
icine for the work of the profession in this 
department. The whole specialty has prac- 
tically been created here, and modes of 
treatment, unthought of in preceding gen- 
erations, have been worked out and pre- 
sented to the profession of the world. This 
would seem to be a great new development 
in surgery. 

I think that there is nothing more in- 
teresting, certainly nothing more valu- 
able, than to call attention to the fact 
that this is not a new chapter in the history 
of medicine, but a revival of an old one. It 
throws great light on the history of medi- 
cine to have our generation reminded that 
there was a preceding phase of laryngology 
and rhinology in which some excellent work 
was done, instruments invented, opera- 
tions devised, technique elaborated and 
undoubtedly great good accomplished; and 
yet practically all of this progress was for- 
gotten, not for a short time, but for cen- 
turies, and the whole work had to be done 
over again. It was done, not in the old 
world where medical and surgical traditions 
might have been expected to be revived, 
but in a new country practically without 
such traditions — here in America where the 
practical genius of the people prompted 
physicians to make their enterprising and 
progressive development of this subject. 

It does not take away any of the credit 
for thorough originality and progressive- 
ness from the New York founders of this 
specialty to tell the story of some of the 
details of an older phase of it, for it is most 
probable that they knew absolutely nothing 
about the historical anticipation of their 

1 For other specific details see address of Dr. D. 
Bryson Delavan. 



work and were intent only on solving, as 
well as possible, the problems which pre- 
sented themselves to them. What is sur- 
prising, of course, is the fact that the medical 
profession should have made a magnificent 
development of laryngology and rhinology 
and then have forgotten about it or lost 
sight of it and ceased to practice it, until 
finally the older knowledge went into desue- 
tude. The same thing happened, not alone 
with regard to this branch of medical and 
surgical knowledge, but also with regard to 
a great many other thoroughly practical 
and extremely valuable developments in 
professional work, and especially in surgical 
practice, made by the same generations 
which brought about the interesting old- 
time evolution of the specialty of diseases 
of the nose and throat. 

For there is no doubt now that the physi- 
cians and surgeons of the thirteenth and 
fourteenth centuries, some of whose work in 
laryngology and rhinology I wish to refer 
to, were using anesthetics and antiseptics, 
and some of them at least knew that pus, in- 
stead of being a necessary accompaniment 
of healing, is an undesirable complication. 
They developed, not only laryngology and 
rhinology, but plastic operations for the 
repair of mutilating wounds of the face, 
including the remaking of the nose, did 
trephining for various conditions within the 
skull, insisted on lifting up depressed bones 
in skull fractures, repaired wounds of the 
intestine, developing a whole interesting 
technique for this purpose. They fashioned 
various kinds of metal tubes to be inserted 
into the intestines in order to maintain the 
patulousness of the viscera during the proc- 
ess of repair, even suggesting the use of the 
trachea of an animal for this purpose, and 
made many other similar surprising antici- 
pations of modern practice supposed to be 
entirely recent in origin. Little wonder, 
then, since all these things were also for- 
gotten, that the advances in laryngology 
and rhinology were lost sight of, but the 



26 



Annals of Medical History 



question as to how such deterioration came 
is a fascinating history problem. Any- 
one who can answer that question in any 
adequate way knows a great deal about the 
history of medicine and surgery — ever so 
much more than I make any pretension to, 
for I must confess that I cannot answer it. 

Surgery degenerated during the seven- 
teenth, eighteenth, and early nineteenth 
centuries. That is the fact. At the same 
time hospitals degenerated, until in the early 
nineteenth century we had the worst hos- 
pitals in the world, though the mediseval 
hospitals had been beautiful in their ex- 
teriors and interiors, marvelously practical, 
well ventilated, with tiled floors that en- 
abled them to be thoroughly cleansed, and 
many other features that make our modern 
hospital architects go back to them for 
suggestions. In the modern period nursing 
reached its lowest ebb in efficiency; the 
professional character of those occupied 
with it was less favorable. As a matter of 
fact always in the history of medicine those 
three coordinate factors — the minimization 
of any one of which at once is a source of 
serious deterioration of the power for good 
of all three — go together — good hospitals, 
good nursing, and good surgery. Whenever 
hospitals deteriorate, nursing does likewise, 
of course, and good surgery becomes im- 
possible; whenever the surgeon does not 
keep the hospital up to its best possibilites 
surgery itself soon suffers. 

It is this chapter of decline in surgery 
during several centuries before our time 
that has hidden from us the significance of 
the older history of medicine. We were in- 
clined to think that if the eighteenth cen- 
tury had neither good surgery nor good 
hospitals and no development of the spe- 
cialties, then surely the seventeenth must 
have had less, the sixteenth still less, and so 
on until the Middle Ages could have had 
almost nothing. As a matter of fact that 
idea of definite gradual progress by which 
mankind is supposed to have worked itself 



up to its present stage of accomplishment 
finds no confirmation in history. The ups 
and downs of history are a commonplace 
to the serious historical student and he 
finds just as much of them in the history of 
medicine and surgery as elsewhere. Great 
advances are made and then forgotten and 
have to be made over again. That is what 
happened with regard to the specialty of 
throat and nose diseases, and it is that story 
that I want to tell, not in detail, but in a 
general way, for those who may be interested 
in this earlier chapter in the history of an 
extremely important specialty that we who 
have practiced in New York have a right 
to claim as our own. 

It is assumed that the history of the spe- 
cialties in medicine begins in comparatively 
recent times, and that indeed this speciali- 
zation of attention and effort represents one 
of the Spenserian processes from homo- 
geneity to heterogeneity which occur in the 
course of evolution. Men are supposed to 
have taken the whole body for their field in 
medicine at the beginning and then with the 
growth of scientific knowledge to have con- 
fined themselves to portions of it, presuma- 
bly greatly to the benefit of their patients. 
This limitation of attention is thought to be a 
matter of the last generation or two and rep- 
resents the great, absolutely new phase of the 
development of medical science which has 
occurred in our time. All of this feeling, 
though a commonplace in the reading world 
of our time, is entirely without foundation 
in any real knowledge of the past. For spe- 
cialism is very old and the surgical spe- 
cialties, though all of them redeveloped 
in our time, have a history well worth trac- 
ing in the older books on medicine and 
surgery. 

In this connection Herodotus has some 
interesting expressions with regard to medi- 
cine in Egypt. The great "father of history," 
though he wrote some 2500 years ago, had 
i fi his attention particularly attracted to the 
•highly developed specialism among the 



History of Laryngology and Rhinology 



27 



Egyptians. He tells us in the quaint lan- 
guage of an old-fashioned English transla- 
tion: 

"Physicke is so studied and prac- 
ticed with the Egyptians that every 
disease hath its several physician who 
striveth to excel in healing that 
one disease and not to be expert in 
curing many. Whereof it cometh that 
every corner of that country is full of 
physicians. Some for the eyes, others 
for the head, many for the teeth, not a 
few for the stomach and the inwards." 

Now here is an historical description of a 
state of things that existed nearly one hun- 
dred generations ago; it makes one think of 
what has actually come to pass in our time, 
a condition which we were inclined to think 
of as eminently modern and, quite surely, 
a very recent development. 

Of course it would be a simple matter to 
think that possibly Herodotus, in order to add 
to the interest of his history, had exaggerated 
somewhat the actual story of specialism 
as it existed among the Egyptians; but 
then we know better, in our time, than to 
accuse Herodotus of perverting the facts 
of history, for no one has ever been so thor- 
oughly confirmed by all our modern docu- 
mentary and archaeological discoveries as 
the great "father of history." A century 
and a half ago it was the custom to make 
sport of his credulity, and Voltaire sug- 
gested that instead of the "father of his- 
tory" he should be called the "father of 
lies." Voltaire, by the way, also thought 
Shakespeare an English barbarian, Dante a 
mediaeval barbarian and Homer a wander- 
ing balladist the like of whom might be 
found on the streets of Paris in Voltaire's 
own day. He also made some slighting re- 
marks about the Almighty. Voltaire found 
it very difficult to understand anyone above 
himself in intellectuality. We know now 
that Herodotus's story of the Egyptian spe- 



cialties was drawn very mildly, and that 
the human body was actually divided into 
some thirty-six regions with specialists for 
each of them; also that a good deal of jeal- 
ousy existed between the specialists when- 
ever they happened to invade one another's 
territory. All of which is not without prac- 
tical interest, even in our enlightened time. 

Probably the Middle Ages would be al- 
most the last period in history where one 
would expect to find any particular devel- 
opment of the surgical specialties. The treat- 
ment, however, of the nose and throat and 
of the eyes received a good deal of attention 
at this time, and we have much documen- 
tary evidence of what was accomplished. 
The first modern medical school was estab- 
lished at salerno, not very far from Naples, 
in connection with the health resort which 
had been established there and which at- 
tracted patients and physicians, not only 
from southern Italy and from Greece, but 
also from the near East, from North Africa 
and from the West of Europe. We know 
that a son of William the Conqueror went 
down there to be cured of an ailment in 
the eleventh century, and that many bish- 
ops and other churchmen went there in 
the twelfth century. Salerno provided an 
excellent medical education in many ways; 
it placed the department of women's dis- 
eases in charge of women, admitted women 
medical students as a matter of course, and 
had very high standards of preliminary and 
actual medical education. Three years of 
preliminary study were required by law, 
four years at medicine, and then a year of 
practice with a physician before the young 
physician was permitted to practice. With 
that in mind it would not be surprising to 
find that even the surgical specialties de- 
veloped down there. 

The first great writer on surgery was 
Roger, sometimes called Roger of Parma, 
and sometimes Roger of Salerno, and he is 
the first independent writer on medicine in 
the Occident after the Arabian times. He 



28 



Annals of Medical History 



lived at the end of the twelfth and the be- 
ginning of the thirteenth century and prob- 
ably wrote his "Practica Chirurgiae" about 
the beginning of the thirteenth century. 
It is usually presumed that these Salernitan 
physicians living in the Mediterranean 
region were deeply influenced by the Arabs, 
above all since, according to a very old tra- 
dition, the founders of Salerno were four 
physicians of very different origin — a Latin, 
a Greek, a Jew, and an Arab. Much was 
made of this supposed dependence on the 
Arabs in the older days, but Gurlt points 
out, after careful study of Roger's work, 
that it abounds in Graecisms, not Arabisms, 
and that evidently Roger was following the 
old Greek tradition of surgery. This is not 
surprising when we remember that the 
southern part of Italy in the neighborhood 
of Naples had been a Greek colony from 
very early times and indeed had been known 
as Magna Grsecia. 2 

Roger has written a very interesting 
description of inflammation of the tonsils 
with its treatment. He calls these organs 

2 Probably the greatest influence at work in the 
organization of the university at Salerno and of the 
medical school around which the University mainly 
came into existence was the Benedictine School at 
Salerno which had been in existence for several cen- 
turies. St. Benedict's greatest foundation was at 
Monte Cassino, not far away, and the Benedictines 
had been very much interested in the school in 
Salerno. That their influence coatinued after the 
foundation of the medical school will be best under- 
stood from the fact that Salerno's greatest writer 
and teacher on medicine in the eleventh century 
was Constantine Africanus, the great African physi- 
cian who had come to Salerno and to whom patients 
came from all over Europe; he wrote the first mod- 
ern textbooks of medicine in existence. Constantine 
and Abbot Desiderius became great friends, and 
indeed, according to tradition, it was' the worthy 
abbot who insisted upon the necessity of Constan- 
tine's writing on the subject of medicine. He finally 
succeeded in getting him to do this, by taking the 
time from a very busy professional life. 

Constantine became so much interested in the 
purely intellectual life of medicine that after a time 
he gave up practice and retired to Monte Cassino 



branchi, or branci, and says that they swell 
interiorly and create, as it were, two al- 
mond-Iike bodies in the throat. As a conse- 
quence of this swelling, expectoration is 
difficult and breathing is conducted with 
anxiety. For this, gargling should first be 
used, and if the patient is not relieved re- 
course should be had to surgery. Then he 
describes how an operation should be done 
on them: 

"Seat the patient before you and 
press his tongue down in his open 
mouth with an instrument, so that 
you can see the tonsils well. Take hold 
of the affected one firmly with a bronze 
or iron hook and incise it with a prop- 
erly sharpened instrument. Leave the 
coverings (the pillars of the fauces) 
which stand next to them uninjured 
however." 

This is of course a description only of 
a simple opening of a tonsillar abscess. 
When the inflammation of the tonsils has 

to be near his friend the Abbot Desiderius and to 
enjoy the quiet life of the monastery. Probably he 
looked forward to years of friendly companionship 
and the satisfaction of mutual intellectual influence. 
Only a few years later, however, the Abbot Deside- 
rius, much against his will and in spite of his re- 
fusals, was chosen Pope, and so Constantine was 
left in the monastery without his friend, the Abbot. 
This seems to have spurred him on to renewed in- 
terest in the intellectual life, in order to fill up the 
void thus created; besides the Pope encouraged him 
in his writing. The result is that we have a number 
of works from Constantine. 

The story is interesting to us here because it 
makes very clear the fact that Benedictine influence 
must have been strong at Salerno, and that the usual 
assumption that Salerno is an Arabian foundation 
or was largely influenced by the Arabs is only a part 
of that tradition which came to be so rife in the eigh- 
teenth century, namely, that it was the Arabs and 
not the Christians who were largely responsible for 
the revival of interest in the intellectual life after 
the coming of the barbarians had so thoroughly 
interfered with the culture of the Roman 
Empire. 



History of Laryngology and Rhinology 



proceeded so far, however, that simple in- 
cision will not cure them, he suggests that 
with instruments made for this purpose 
they should be completely removed. His 
Latin words for this, "et a radice junditus, 
evellantur," which may be translated 
literally, "plucked away entirely by the 
roots," probably is responsible for our use 
of the expression, "under similar circum- 
stances radical operation." 

Manifestly there were a number of ob- 
servations made on diseases of the thro'at in 
Roger's time and so we are not surprised 
to find, a little farther on, a description of 
a serious condition near the epiglottis 
which impeded the voice and obstructed 
the trachea, and which can be cured only 
by surgical intervention. Gurlt does not 
hesitate to say that in this Roger was 
probably describing edema of the glottis. 
Apparently this condition had been recog- 
nized and some mode of treating it dis- 
cussed, though in his book on surgery 
Roger only refers to it indirectly. 

In elongation of the uvula Roger sug- 
gested first the use of medicaments in 
powder form and then the application of 
gargles. 

"If however, the uvula can not be 
made to shrink in this way then it 
should be grasped with a forceps made 
for this purpose near the palate where 
the uvula itself is sometimes of smaller 
diameter and snipped off. Care should 
be taken, however, not to touch the 
roots of the uvula." 

Here evidently he was warning against the 
radical operation, though in the removal 
of the tonsils he encouraged thorough 
radicalness. What is constantly surprising 
in Roger's work is the mention of various 
special instruments for these purposes. 

Angina was described by Roger under 
the name squinancia, and evidently had 



been studied with a good deal of care. It 
was differentiated into three varieties with 
slightly different names : squinancia, a very 
severe form; sdnomda, a milder form, and 
finally quinancia, of which the prognosis 
was always good. The symptoms were 
practically all the same — difficulty of in- 
spiration and expiration as well as difficulty 
in swallowing both food and drink. Some- 
times the voice was completely interfered 
with and the saliva could not be swallowed 
nor the sputum emitted. The first form of 
the disease, squinancia, was located between 
the trachea — which, because it carried air 
was called at that time trachea arteria — 
and the esophagus, at a place called the 
isthmus. Its prognosis was very fatal and 
its cure was to be left to God alone. The 
second form, scinancia, much less severe or 
malignant— Roland's exact word is "ma- 
liciosa" — had for its characteristic lesion the 
development of pus, partly deep in the tis- 
sues but partly on the surface. The descrip- 
tion evidently refers to what we call retro- 
pharyngeal abscess, the severer form being 
retro -esophageal abscess. Roger suggests 
that the retropharyngeal abscess can be 
ruptured with the finger or with some in- 
strument, and that it is always well to do 
this as soon as pus has formed. He said 
that he had cured some patients with his 
own hand in this way. 

This form of the affection he suggested 
might be treated as follows: He confesses 
that it is something of an experiment and 
uses the word " experimentum." 

"Take of salt beef, half cooked, of 
the size and shape of a chestnut or a 
filbert, 3 and having fastened it firmly 
by a long silken cord have the patient 
swallow it and then let the physician 
pull it out suddenly and violently 
(cum violentia) in order that the ab- 
scess may be ruptured." 

* Old-fashioned filberts were larger than ours. 



30 



Annals oj Medical History 



Quinancia was to be treated by gargles, 
applications, venesection from the sub- 
lingual vein, and these methods were to 
be used at first also in the other forms of 
the affection. 

In the same chapter Roger treats of 
goiter and suggests various applications, 
but considers also in the severe forms the 
necessity for extirpation. He warns against 
any attempt to remove large goiters, but 
suggests that a temporary ligature of the 
goiter might be made and then a subse- 
quent radical removal. Evidently a favorite 
palliative mode of treatment of his was 
cauterization with the hot iron and some- 
times even penetration of the goiter in 
that way. 

While Roger is the first of the western 
surgeons who wrote a treatise on this sub- 
ject, he was very soon followed by Roland, 
a pupil whose work contains very little of 
importance that was not covered by his 
master, but who adds some personal com- 
ments which serve to show that men were 
thinking seriously about a great many 
surgical problems and solving them very 
well. 

These two were followed in a few years 
by the "Textbook of the Four Masters," 
since famous in the history of medicine 
and surgery. Manifestly within the first 
century, probably indeed within the first 
fifty years of western surgical writing, it 
was recognized that a group of men could 
make a more complete textbook than a 
single man. It is usually thought that the 
"Four Masters" were Archimatteo, Petron- 
cello, Plateario, and Ferrario. Of these only 
Plateario, or Platearius, is known apart 
from this book, for he was the son or the 
grandson of Platearius and Trotula, Pla- 
tearius having been the Professor of Medi- 
cine and Trotula the Professor of Women's 
Diseases and the head of that department 
in the medical school of the University of 
Salerno, and for several generations their 
sons and grandsons continued to be prom- 



inent in the teaching staff of that 
school. 

The next important writer on surgery 
in Italy, after Roland and Roger and the 
"Four Masters," was Bruno of Longoburgo, 
who was born down in Calabria — the heel 
of the Italian boot, as the name of his birth- 
place attached to his Christian name indi- 
cates — and who was probably a student at 
Salerno. In the Latin literature of the time, 
for of course all wrote in Latin, his name 
was Brunus and it is usually under this 
name that he is quoted. Though he studied 
in the south of Italy he practiced and taught 
in Verona and Padua. His book "Chirurgia 
Magna" was finished at Padua, as he him- 
self declares toward the end of it, in Janu- 
ary, 1252. His volume is noteworthy, mainly 
for the reason that he was the first of these 
mediaeval surgeons of the West to quote not 
only the Greeks, but the Arabs. Arabian 
influence was an afterthought and a sub- 
sidiary factor, and not the origin of this 
mediaeval surgery, as it is often declared 
to be by those who theorize without weighing 
the facts of chronology. 

Bruno, to use his Italian name, has much 
to say of the treatment of various intrana- 
sal pathological conditions which disturb 
breathing. He describes several varieties 
of nasal polyps and differentiates one of 
them as a "malignant tumor." This was 
of darker color, of slight sensibility and was 
very hard. He advised against operation 
upon it and suggested that it should not be 
touched, as surgical intervention merely 
hastened its growth and made the patient 
worse. 

With regard to the removal of polyps 
he quotes Abulcasim, or Albucasis, the 
Moorish physician, special medical attend- 
ant of the Khalif el-Hakim III (961-976). 
Albulcasim, who flourished in the second 
half of the tenth century, wrote a very com- 
prehensive medical and surgical work under 
the title "Altasrif" or "Tesrif," in some 
thirty books. This Moorish physician, who 



History of Laryngology and Rhinology 



3i 



is quoted by Bruno, suggests the removal 
of polyps by drawing them down with a 
hook, severing the connecting portion with 
a knife, and then shaving off any projection 
that may remain. The cautery was used 
to prevent recurrence and to assure the 
freedom of the nose for breathing. Bruno 
suggests that the root of the polyp should 
be cauterized with a hot iron or with some 
cauterizing material. He adds that some- 
times the use of a cauterizing substance is 
quite sufficient to destroy a polyp and pre- 
vent its recurrence. 

Bruno next discusses obstructions of the 
nasal passages which may occur from over- 
growths in the back part of the nose, in the 
nose and throat space. For the treatment 
of these he quotes Paul of iEgina, the most 
famous medical writer of the late Greek 
time, of whose career we know so little, 
however, that differing authorities place 
him anywhere from the fourth to the sev- 
enth century a.d. Paul suggested that a 
ligature with knots at intervals should be 
passed through a tube into the nose and 
then brought out through the mouth and 
by to-and-fro motion employed to cut off 
projecting growths at the back of the 
nose. After this, cauterizing materials were 
to be used to prevent recurrence. Bruno 
seems to have been quite satisfied that he 
could make the nose patulous in this way 
and greatly relieve the patient and prevent 
the development of complications. 

It may seem surprising that a surgeon in 
the middle of the thirteenth century should 
have so much surgical sense, but when it is 
recalled that Bruno was the originator of 
the expression "union by first intention," 
it will be easier to comprehend. That ex- 
pression, so familiar in the modern times, 
has of course no significance in any modern 
language except what is lent to it by the 
old mediaeval Latin, unio per primam in- 
tentionem. Bruno knew exactly what he 
was talking about when he used it, for he 
had seen wounds heal without pus and he 



knew that this was the ideal way for heal- 
ing to occur. His great contemporary, 
Theodoric, whose textbook appeared some 
ten years later, declared quite explicitly: 

"It is not necessary, as Roger and 
Roland have taught and as many of 
their disciples are still teaching and 
as all modern 4 surgeons profess, that 
pus should be generated in wounds.. 
No error can be greater than this. Such 
a practice is indeed to hinder nature, 
to prolong the disease, and to prevent 
the conglutination and consolidation 
of the wound." 

Theodoric himself copies Bruno with 
regard to operations within the nose, and 
has something special to say with regard 
to nasal repair after injuries. Every possible 
portion should be saved and if a part of 
the nose hang down this should be re- 
placed and very carefully sewed on again. 
A pledget of silk soaked in warm wine 
of proper thickness and length should be 
inserted into the nostrils in order to main- 
tain the parts in their proper places just 
as far as possible. If the patient's breathing, 
disturbed by this procedure, threatens in 
any way to interfere with the success of 
the operation, then the pledget of silk should 
have a goose quill run through it in order 
to facilitate breathing. The older medical 
and surgical authorities, especially Paul of 
^gina and Hippocrates, had suggested a 
tube made of lead, but Theodoric found a 
quill much more cleanly and less bothersome. 

Theodoric has a good deal to say about 
the possibilities of repair of disfiguring 
wounds of the face and is a distinct pioneer 
in plastic surgery. His use of strong wine as 
the only dressing, his insistence on the ab- 
sence of manipulation and his advice not 
to remove the dry dressing, as it was called — 
because after a time the strong wine evap- 

4 How curious this use of the word "modern" 
seems just after the middle of the thirteenth century. 



32 



Annals of Medical History 



orated, leaving the dressings perfectly dry — 
gave him abundant opportunity for secur- 
ing such healing as would provide the best 
results. He did not hesitate to say, when a 
surgeon made an incision in a hitherto 
unbroken part, that if pus developed in it 
that complication was due to the surgeon's 
error — his manipulations were at fault. For 
this reason he advised against sewing up 
wounds of the scalp, though he giyes a 
number of details of the procedure that 
should be employed to bring the parts care- 
fully together and, by proper bandaging 
and pressure, to keep them together. 

Strange as it may seem, Theodoric was 
a bishop as well as a surgeon and had been 
a member of the Dominican Order. His 
textbook of surgery published in the Vene- 
tian Collection of surgical works in 1498 
makes that fact very clear. He is the first 
surgical writer who definitely mentions the 
use of an anaesthetic during operations. 
He says that its introduction was due to 
his father Ugo, or Hugh, of Lucca, as he is 
called, who is known to have been a great 
surgeon, but who wrote nothing, and whose 
fame is preserved only through his son's 
writings. Ugo of Lucca, or Hugh Bor- 
gognoni, to use the family name that he 
and his three physician sons employed, had 
been a surgeon to the crusaders about 1218 
and was present at the siege of Damietta. 
After his return he was made the City 
Physician of Bologna, to whom not only 
matters of health but also of medico-legal 
significance were referred. His appointment 
and the statutes granting him powers are 
the first documents in the history of legal 
medicine in modern times. 

Theodoric wrote of his father's experi- 
ences and those of his brothers as well as 
his own. Many of these details of surgical 
technique had been carefully treasured as 
secrets up to this time and transmitted as 
family heritages, as among the Asclepiadean 
families in the olden time. Theodoric broke 
this tradition and published them for the 



benefit of humanity in his own and sub- 
sequent generations. Among other things, 
he gave us, particularly, as we have said, 
the method of producing narcosis, evi- 
dently carefully worked out so as to make 
it possible that extensive surgical work 
might be done on a patient without his feel- 
ing it, or but to a slight degree, and yet 
without any serious risk of his not awaking 
at the end of the operation. 

Theodoric's description of the mode of 
obtaining anesthesia practiced by his father 
is as follows: 

"Having made a mixture of the 
wine extracts of opium, hemlock, man- 
dragora, unripe mulberries and wild 
lettuce, a sponge should be boiled in 
this fluid until all is boiled away, and 
then whenever anesthesia is wanted 
this sponge should be placed in warm 
water for an hour and applied to the 
nostrils until the patient sleeps, when 
the surgical operation should be per- 
formed. At its end another sponge 
dipped in vinegar should be frequently 
applied to the nostrils, or some of the 
juice of the root of hay should be in- 
jected into the nostrils, when the pa- 
tient will soon awaken." 

A mode of anesthesia resembling this in 
many respects is described by Guy de 
Chauliac after the middle of the fourteenth 
century, so that there seems to be no doubt 
that for several centuries operations in 
Europe were done under the influence 
of an anesthetic and that the practice was 
reasonably successful. It is easy to under- 
stand that it was neither so safe nor so sure 
as our practice in the matter. The surprise is 
that it should have existed, and for so long, 
and then have been entirely forgotten, so 
that the very idea of an anesthetic came 
as a surprise to the mid-nineteenth century. 
As a matter of fact the English poet Middle- 
ton mentions "the pities of old surgeons" 



The Chasseurs d'Alpin 



33 



and how they put them to sleep before 
cutting them, and there are other literary- 
passages to the same purport; but readers 
used to think that these represented poetic 
licenses or were due to the writers' imagina- 
tion, the poets' enthusiasm spurring them 
on to tell things that would have been ideal 
had they existed, though in reality they 
never did. 

We know otherwise now, and knowing 
the generations that practiced both anes- 
thesia and antisepsis we are not surprised 



to find among them developments of the 
specialty of the nose and throat which 
would otherwise have seemed almost in- 
credible. How curious it is, however, to 
find that these two great cycles of develop- 
ment of surgery, including the specialties, 
should be separated in their initial stages 
at least by seven centuries. The student of 
history who can explain the reason for the 
interval between these two cycles of ad- 
vance knows something about human his- 
tory and its philosophy. 



THE CHASSEURS D'ALPIN 



(The "shock troops" of the French army) 



See the Chasseurs marching through 
To the front. To the front. 

They have Titan's work to do, 
Bear the brunt! 

O'er the top and through the grass, 

Suffocating with the gas 

'Mongst the barbed wire they pass. 
'Tis their wont. 



Pause while they are passing by, 

Contemplate. Meditate. 
'Tis a goodly company — 

Venerate. 
They shah save the Fleurs de Lys, 
They shall help us, over seas, 
Keep our ancient liberties 
Inviolate. 



Last resource in direst need 
On they go. Forward go. 

They will die or they'll succeed 
O'er the foe. 

Hand grenade and glassy steel, 

Down and up, and on they reel. 

What must be the joy they feel! 
'Twas ever so. 

They are called the troops of shock. 

Sturdy men. Heroic men. 
Each attack 'tis theirs to block. 

Charge again! 
Counter-charge the Hunnish horde, 
Purge the pride of Prussia's lord, 
Cause a cost he'll ill afford. 

One for ten! 



Here a cross and there a mound, 
Thus they sleep. Silent sleep. 

Sheltered by the kindly ground. 
Vigil keep! 

For they have not died in vain, 

In the groves of Compiegne. 

Still their spirits fight again 
And glory reap. 

Traveler, plait a laurel wreath 

Of a girth, majestic girth. 
Lay it where they sleep beneath 

With Mother Earth. 
So may rose and twisting vine 
With the laurel intertwine, 
Nature's ever vernal shrine 
To their worth. 



Carleton B. McCulloch, M.D. 
May, 1918. 



MODERN COMMENTARIES ON HIPPOCRATES 1 
By JONATHAN WRIGHT, M.D. 

PLEASANTVILLE, N. Y. 

PART I 



PERHAPS it is not the only way, but 
one of the ways of judging of the 
excellence of a work of science or 
literature is to take note of the 
discussion the author has elicited in less 
talented readers and the stimulation of 
the faculties thereby evidenced. In the 
conceit and braggadocio of Falstaff, aside 
from his being the butt of jokes, we 
perceive he is conscious of the quality of 
his mind when he says he is not only witty 
himself, but is the cause of wit in others. 

There is no standard of truth whereby 
the accuracy of theory and practice of one 
age can be judged by another, though there 
are underlying general principles which per- 
sist as much perhaps by their vagueness 
and lack of limitation and inclusiveness as 
by their validity, but, for the most part, 
time withers most specific facts as they 
were apprehended two thousand or more 
years ago. When, however, a discourse, an 
oration, a poem, a philosophical treatise, or 
a narrative continues for generation after 
generation, century after century, for ages, 
to excite the comment of readers, as do, 
for instance, those of Homer, Herodotus, 
Hippocrates, Horace, Virgil, we are safe in 
recognizing in that objective evidence the 
proof of an inherent excellence which per- 
haps our own faculties do not reveal to us. 
Subjective testimony is of little interest 
to us. We care not if the intellectual crea- 
ture at our side adores Ibsen — we might 
hate him; or if the man in the street reads 
Kipling to-day — to-morrow he may likely 
never give him a thought. It need not 



disturb us if Plato is thought by the young 
lady at the library to have written some- 
thing on astronomy or if the man who 
preaches in our church thinks Aristotle 
was a monk. We ourselves may be unable 
to get up any enthusiasm for either. But 
when we learn that all these men have by 
their words tapped the ocean of thought in 
every era of civilization since they lived 
and at their magic touch abundant streams 
of mental activity have gone forth to enrich 
the world, when we once realize what an 
ever living power they still exercise over the 
best minds which humanity produces, then 
what Dotty says about Ibsen or what Bill 
Broker thinks of Kipling, that the Reverend 
Mr. Stiggins is mistaken about Aristotle, 
or that we ourselves fall asleep or our 
minds wander when we read the "Phae- 
drus" of Plato or the "Poetics" of Aris- 
totle, is of no consequence. It is a subjec- 
tivity which has nothing in the least to do 
with the quality of the writer's works; 
that we must judge of from what we come 
to know of the phenomena which the 
history of thought furnishes us. 

The acknowledgment of this as a reality 
is common enough, so common as to have 
become perfunctory and of course occa- 
sionally a little ostentatious, but it is seldom 
the subject of analysis. Why is it, then, 
that these master artists continue to be 
the wellsprings of thought and the or igin, 
usually unrecognized, of inspiration? Cer- 
tainly not because of the facts they display. 
These are denied or discredited in a short 
time; but through every vicissitude of 



1 The translations of Francis Adams' Hippocrates, "Genuine Works," v. i. New York: William Wood 
& Co., and E. Littre's Hippocrates, "(Euvres completes." Paris: J.-B. Bailliere, 1 839-1 845. These 
volumes h ave been chiefly used and compared with Littre's Greek text. 

34 



Modern Commentaries on Hippocrates 



35 



theory and every turn in the current of 
thought, often very shallow, the influence 
remains profound. Their language is an 
unknown tongue to many, at least in so far 
as the finer shades of meaning or of sym- 
metry of form in their more recondite sense 
are concerned. The charm of rhythm or 
the subtlety that goes with rhetorical 
effect is often lost to us. Thus we might 
proceed in an attempt to understand why 
such men have dominated the thoughts of 
posterity, but our endeavors at analysis are 
defeated and we are driven to extend the 
many definitions of genius to a pragmatical 
conclusion that success in its age-long 
demonstration is the weightiest factor in 
our understanding of genius. In this con- 
nection, however, that is inclusive of that 
boast of the old debauchee whom Shake- 
speare's art has created for us — they are 
the cause of wit in others. 

No remark, preliminary to the study of 
the writings of Hippocrates, is more help- 
ful than the observation of Littre, who 
in substance pointed out that while to-day 
we study disease as an entity and follow 
the forces of each one from their origin to 
their post-mortem manifestations, Hippoc- 
rates studied man and the reactions he 
exhibits to his manifold environment. It is 
the phenomenon presented by man and 
what it indicates as to the probable result 
as regards man which he conceived as the 
chief object of medical study. It requires 
no very deep reflection to realize that there 
is a material discrimination to be made 
psychologically between the concept of 
disease and the conception of a diseased 
man. For the former we seek the literature 
of medicine which has appeared in the 
last hundred years, for the latter the litera- 
ture which, originating with Hippocrates, 
fills the thousands of years which have 
elapsed since he in his time wrote "On 
Ancient Medicine." In this essay and in 
the one following, "On Airs, Waters, and 
Places," more than in some of his other 



treatises, he brings the remote causes of 
disease and general philosophical conclu- 
sions more into prominence. On the other 
hand, in taking up "The Prognostics" we 
observe that it is entirely founded on obser- 
vation. If Hippocrates gathered this ex- 
perience from the records of clinical obser- 
vation made by himself and by other priests 
in the temples of iEscuIapius, we find that 
the methods of observation, which served 
as the basis of a priestly and magical inter- 
pretation, served also for the beginnings of 
rational medicine. How it came about that 
historians have ascribed to Hippocrates 
the fame of being the first to question 
nature would furnish an interesting and 
instructive example of how Baconians have 
perverted the plain indications of history. 
Evidence has shown Babylonian priests 
taking meticulous care for unnumbered 
centuries in recording facts and their se- 
quences, phenomena they observed in the 
heavens and in the entrails of animals and 
the mundane events, important to man, 
which followed the observations. They 
observed and questioned nature, but they 
did not reason right. 

When Ermerins, whom Adams quotes, 
made the remarks which follow he only 
partly disclosed the reform wrought in 
the ranks of the Asclepiadse, before the 
epoch and during the time of Hippocrates, 
who was their spokesman: 

The readers must particularly keep before 
their eyes this origin and the antiquity of 
those writings if they would pass a correct judg- 
ment on the merits of the Asclepiadae towards 
the art of medicine. Whatever in their works 
we have the pleasure of possessing, all attest 
the infancy of the art; many things are imper- 
fect, and not unfrequently do we see them, while 
in the pursuit of truth, groping, as it were, and 
proceeding with uncertain steps, like men 
wandering about in darkness; but yet the 
method which they applied, and to which they 
would seem to have betaken themselves of their 
own accord, was so excellent that nothing could 
surpass it. It was the same method which 
Hippocrates himself always adopted, and which, 



36 



Annals oj Medical History 



in fine, Lord Bacon, many ages afterward, 
commended as the only instrument by which 
truth in medicine can be found out. 

As a matter of fact they inherited their 
method from the rules of the practice of 
magic, the observation of the stars, the 
flight of birds and the entrails of animals. 
They turned from these observations to 
observations on the phenomena of disease. 
They recorded one just as they recorded 
the other, on the walls of temples and on 
their tablets. What the Asclepiadse really 
did was to turn away not from habits of 
the observation of nature, which we cherish, 
but from irrational methods of thought. 
They reformed the rules of logic, but they 
did not introduce the inductive method; 
it was already hoary with age. 

Although Hippocrates criticised the 
methods of the Nature philosophers he 
resorted almost as freely as they to theory 
building. Dr. Ermerins himself basks in 
the comfort furnished by theories of vital 
force rampant in his day. The neovitalism 
of the nineteenth century had its roots 
deep in human nature, and it still draws its 
sustenance from that same fundamental 
mystery which shrouded cosmic laws from 
the gaze of Babylonian and Baconian alike. 
The modern man of science must acknowl- 
edge its existence, but when he tries to 
shelter himself from his difficulties in the 
practical search of truth by a resort to the 
covert of vitalism he enters the tomb in 
which the human mind was imprisoned 
before the era of Thales and of Hippocrates. 
It was emancipation from this and not the 
introduction of inductive philosophy, which 
we owe to Hippocrates and his forbears. 
The inductive philosophy of Bacon was the 
basis of the method that primitive man 
adopted when he began to develop the 
memory of his cognitions. To judge from 
the conventional remarks in regard to it 
one might suppose it had never existed in 
the world before the time of Lord Bacon, 
or at least of Hippocrates. Succinctly 



stated, this method, which has achieved 
such an apparent ascendancy in our day, 
is to proceed from the study of the particu- 
lar to the general, to collate facts by obser- 
vation and experiment and from them to 
deduce the conclusions which are to be 
applied to the conduct of life and the further 
investigations of the laws of nature. 

In the quotation from the thesis of Dr. 
Ermerins which Adams has made, it will 
be noted that Dr. Ermerins commends 
Hippocrates for being a Baconian. Noth- 
ing, perhaps, is more diametrically opposed 
to the doctrines of Bacon than those of 
Plato, 2 yet in one of his dialogues we find 
him claiming Hippocrates' support. Socrates 
in the "Phsedrus" asks if the nature of 
the soul can be intelligently studied with- 
out knowing the nature of the whole and 
the answer is: "Hippocrates, the Asclepiad, 
says that this is the only method of pro- 
cedure by which the nature even of the body 
can be understood." Hippocrates was the 
slave of no method. He was the critic and 
the analyst not only of the problems of 
nature, but of the methods of men who 
sought to know them. 

If we are to apply the Baconian doctrine 
rigorously and without the compromise 
that common sense gives to all things, the 
student cannot start with certain conclu- 
sions of a general character, arrived at by 
methods of which he must necessarily be 
ignorant, but he must begin ab initio and 
build up his foundation from the apper- 
ceptions of primitive man to the level of 
his first entrance into medicine proper, or 
in a state of entire ignorance he must face 
a task to which, even in Hippocrates' day, 
a trained mind stored with the experience 
of others alone was adequate. Plato had 
his opinion how best to train that mind 
and Hippocrates had another, but in the 
contact noted by Littre their point of 
agreement, as evident to the most bigoted 

2 "The Dialogues of Plato," tr. by B. Jowett. 
New York: Charles Scribner's Sons, 191 1. 4 v. 



Modern Commentaries on Hippocrates 



37 



Baconian as to Platonist, lay in the fact 
that training was as necessary for the be- 
ginning of the study of the soul as for the 
beginning of the study of the body. 

The problem of the method of science is 
at once encountered in the first lines of 
"On Ancient Medicine": 

Whoever, having undertaken to speak or 
write on ancient medicine have first laid down for 
themselves some hypothesis to their argument, 
such as hot or cold or moist or dry, or whatever 
else they choose, thus reducing their subject 
within a narrow compass and supposing only 
one or two original causes of disease or of death 
among mankind, are all clearly mistaken in 
much they say. 

There seems no reason to doubt the 
validity of the arguments Littre advances 
for supposing that the tract on "The Nature 
of Man" was written by Polybus, the son- 
in-law of Hippocrates, as Aristotle, almost 
a contemporary, asserts. In it, however, 
we get a reversion to the criticism Hippoc- 
rates thus visits upon the ancient Nature 
Philosophers in the opening sentences of 
his essay "On Ancient Medicine": 

According to one, the air is the unique and 
only thing, to another fire, another water, 
another earth, and each one sustains his reason- 
ing by evidence and arguments which are of 
weight. . . . They pretend, indeed, that there 
is a single substance, arbitrarily chosen and 
named by each, and that this substance changes 
its appearance and its nature under the influence 
of the hot and the cold becoming in a manner 
soft, bitter, white, black and all the rest. 

He will have none of it and advances 
his own arguments, which partake of those 
of Alcmaeon and the theory of crasis, of 
equilibrium of the mixtures in the blood, 
the mucus, the yellow and the black bile 
in which we find an explanation of the 
nature of man and what makes the differ- 
ence between disease and health. He sub- 
stitutes one theory for another, and in this 
he sins no more plainly than his father-in- 
law, Hippocrates, against the first precepts 



of "On Ancient Medicine," in that essay 
itself and in others. 

It is difficult to find the origin of the idea 
of the qualities, the moist, the dry, the hot, 
and the cold, which after the time of Hippoc- 
rates became increasingly more prominent 
in medical writings until Galen transmitted 
them through the Dark Ages and the 
Renaissance to almost our own century. 
Traces of the formulation of these attributes 
of matter may be found even in the "Rig 
Veda." It is therefore of secondary impor- 
tance to discover whom Hippocrates had 
in mind as the originator of the theories 
he attacked. Anaximenes, 3 Parmenides, 3 
Anaxagoras, 3 Heraclitus, 4 and many other 
predecessors of Hippocrates doubtless made 
it a part of their scheme of things, but it 
originated with none of them. Like the 
elements of fire, air, earth, and water, like 
the blood, the breath, and the soul, as a 
definition of life they belong to the funda- 
mentals in the primitive thought of man- 
kind. These hypotheses, we are to infer 
from the remarks of Hippocrates and his 
followers, were to be avoided, but by no 
means the records of those observations of 
phenomena whereby the nature of disease 
had in the past been manifested to others : 

For there are practitioners, some bad and 
some far otherwise, which, if there had been 
no such thing as medicine, and if nothing had 
been investigated or found out in it, would not 
have been the case, but all would have been 
equally unskilled and ignorant of it, and every- 
thing concerning the sick would have been 
directed by chance. 

Then he proceeds to resume his fling at 
the Nature Philosophers who before him 
have adopted the hypotheses to which he 
specifically alludes: 

3 "The First Philosophers of Greece," by Arthur 
Fairbanks. New York: Charles Scribner's Sons, 
1898. 

4 "Early Greek Philosophy," by John Burnet. 
2 ed. London: Adam & Charles Black, 1908. 



38 



Annals oj Medical History 



I have not thought that it stood in need of 
an empty hypothesis, like those subjects which 
are occult and dubious, in attempting to handle 
which it is necessary to use some hypothesis; 
as, for example, with regard to things above 
us and things below the earth. 

Singular to say, the Platonic Socrates 
rejected them for another reason — not be- 
cause they were too theoretical, but because 
they were not theoretical enough, because 
they were too materialistic, we would say. 
He remarked to Cebes in the "Phsedo" 6 
that there was a time when he thought he 
understood what was what — "the meaning 
of greater and less pretty well" — but now 
" I am no longer satisfied that I understand 
the reason why one or anything else either 
is generated or destroyed or is at all, but I 
have in my mind some confused notion of 
another method, and can never admit this." 
He had once been much troubled about 
such matters. 

Then I heard some one who had a book of 
Anaxagoras, as he said, out of which he read 
that mind was the disposer and cause of all, 
and I was quite delighted at the notion of this, 
which appeared admirable, and I said to myself: 
If mind is the disposer, mind will dispose all 
for the best, and put each particular in the best 
place; and I argued that if any one desired to 
find out the cause of the generation or destruc- 
tion or existence of anything, he must find out 
what state of being or suffering or doing was 
best for that thing, and therefore a man had 
only to consider the best for himself and others, 
and then he would also know the worse, for 
that the same science comprised both. And I 
rejoiced to think that I had found in Anaxagoras 
a teacher of the causes of existence such as I 
desired, and I imagined that he would tell me 
first whether the earth is flat or round; and then 
he would further explain the cause and the 
necessity of this, and would teach me the nature 
of the best and show that this was best; and if 
he said that the earth was in the center, he 
would explain that this position was the best, 
and I should be satisfied if this were shown to 
me, and not want any other sort of cause. 

6 "The Dialogues of Plato," tr. by B. Jowett. 
New York: Charles Scribner's Sons, 191 1. 4 v. 



As he sits there in prison awaiting among 
his weeping disciples the time for drinking 
the hemlock, his irony and his humor 
break forth: 

What hopes I had formed, and how grievous- 
ly was I disappointed! As I proceeded, I found 
my philosopher altogether forsaking mind or 
any other principle of order, but having recourse 
to air, and ether, and water, and other eccen- 
tricities. I might compare him to a person who 
began by maintaining generally that mind is 
the cause of the actions of Socrates, but who, 
when he endeavored to explain the causes of 
my several actions in detail, went on to show 
that I sit here because my body is made up of 
bones and muscles; and the bones, as he would 
say, are hard and have ligaments which divide 
them, and the muscles are elastic, and they cover 
the bones, which have also a covering or environ- 
ment of flesh and skin which contains them; 
and as the bones are lifted at their joints by 
the contraction or relaxation of the muscles, 
I am able to bend my limbs, and this is why I 
am sitting here in a curved posture; that is 
what he would say, and he would have a similar 
explanation of my talking to you, which he 
would attribute to sound and air, and hearing, 
and he would assign ten thousand other causes 
of the same sort, forgetting to mention the 
true cause, which is, that the Athenians have 
thought fit to condemn me, and accordingly 
I have thought it better and more right to 
remain here and undergo my sentence; for I 
am inclined to think that these muscles and 
bones of mine would have gone off to Megara 
or Bceotia, by the dog of Egypt they would, 
if they had been guided only by their own idea 
of what was best, and if I had not chosen as 
the better and nobler part, instead of playing 
truant and running away, to undergo any 
punishment which the state inflicts. There 
is surely a strange confusion of causes and 
conditions in all this. It may be said, indeed, 
that without bones and muscles and the other 
parts of the body I cannot execute my purposes. 
But to say that I do as I do because of them, 
and that this is the way in which mind acts, and 
not from the choice of the best, is a very care- 
less and idle mode of speaking. 

I suppose reasoning of this kind taken as 
a model for logic ultimately led to the quips 
and plays on words and puerilities found in 



Modern Commentaries on Hippocrates 



39 



many of the books of the pre-renaissance 
period. Here half in jest, half in earnest in 
the mouth of Socrates, sitting there awaiting 
death, Plato has put it in a strikingly 
dramatic setting. It is not ridiculous and 
pedantic; it is saved from that by the trag- 
edy of the scene, which has indeed become 
one of the great world tragedies for us. This 
saving grace of the sublime has preserved 
for us the grain of truth which lies in much 
of the chaff of Socrates, which was lost in 
the maudlin pedantry of monastic philoso- 
phy. I do not know whether or not Galen 
also was jesting, but this Socratic discourse 
always reminds me of what he says of the 
recurrent laryngeal nerves 6 to which I 
have elsewhere drawn attention. At any 
rate he sets forth the argument also in 
anatomical terms and ascribes it to the 
Stoics. If that is so, the Platonic dialogue 
I have quoted probably is influenced by 
the same sophism. Galen says the Stoics 
reasoned thus: "It is evident the voice 
cometh from the mind. It is also evident it 
cometh from the larynx. Hence the mind is 
not in the brain." Galen demolished this 
sophism thus : 

They will wonder when they hear the voice 
is produced from the brain, and much more 
after having heard that all voluntary motion is 
performed by the muscles. . . . For the mus- 
cles move certain parts upon which the breath- 
ing and the voice depend, and they themselves 
in their turn are dependent on the nerves from 
the brain. If you surround any one of these with 
a ligature, or if you cut it, you will render the 
muscle to which it is distributed motionless, as 
well as the limb of the animal which has moved 
before the nerve was cut. 

I take it this is satisfactory to twentieth 
century materialists, but after all the pigs 
on whom Galen seems to have experimented 
have a larynx and recurrent nerves, and 
however learned they may be at the circus, 
a four-legged variety do not talk, so I 

6 "History of Laryngology," by Jonathan Wright. 
2d ed. revised and enlarged. Philadelphia and New 
York: Lea & Febiger, 19 14. 



prefer to believe with Zeno and Socrates 
that the mind is an organ of the voice, and 
that Galen's criticism is a confused and 
presumptuous tampering with logic and 
dialectics, in which he was practiced but 
in which he was not an adept. I may have 
seemed to wander a little from the subject 
of the method of science, but the matter I 
have introduced serves to illustrate that it 
is not sufficient experimentally to cut or 
stimulate the recurrent laryngeal nerves 
and to observe the sequence of events; 
it is necessary to take into view the differ- 
ences between a man's voice and that of a 
pig. Those who are familiar with the 
technical experiences elicited from an ex- 
perimental study of the laryngeal nerves a 
generation ago will appreciate the necessity 
for the erection of some hypothesis looking 
to this discrimination. The acceptation of 
theory erected on the experience of others 
and rationalistic deductions from it are 
absolutely necessary for progression beyond 
the possibilities of mental activity open to 
primitive man. 

Littre has included in his edition of the 
complete works of Hippocrates a little 
tractate of unknown authorship, "The 
Precepts." In it we get a glimpse of the 
opinions of Hippocrates. It is elaborated 
from the passages we are concerned with 
in the essay "On Ancient Medicine" or 
from some of the other genuine books. 
Perhaps it is from his own hand. I think 
the sentiments there expressed perhaps are 
a nearer approach to the method of Hippoc- 
rates than the Baconian which has been 
foisted on him by the distorted vision of 
more recent admirers. He who knows that 
in time occurs the opportunity and in the 
opportunity a brief time: 

In order to practice medicine, should devote 
himself not at first to the probability of reason- 
ing, but to reasoned experience. Reasoning is 
a sort of synthesis of all that has been perceived 
by the senses. ... I praise, therefore, all the 
reasoning faculty, if it takes its departure from 



40 



Annals oj Medical History 



the observation and evolves its deductions 
from the facts as they appear. . . . Intelligence 
starting from it, as I have said, leads to the 
truth. 

This is a fair summary of the critical 
argument in the essay "On Ancient Medi- 
cine" as to the method of science in which 
some have recognized the Baconian system, 
but it is modified in such a way as to appeal 
to common sense. 

There is no one who has done more to 
advance what we believe is our knowledge 
of the physics of matter than Clerk Max- 
well. It is not of vital importance whether 
the theories that follow from mathematical 
and logical deductions from the phenomena 
of the universe are true or not. It is quite as 
impossible for me to think of an ether of 
perfect density yet of perfect elasticity, 
demanded by some of them, as it is for me 
to think of influence exerted at a distance 
through a vacuum, but if the theories 
work to the end of the discovery of facts 
in their proper sequence, if they are prag- 
matical, though they may be far from rep- 
resenting actual facts in themselves, if they 
suffice for this, we need have no concern 
as to their own truth. Most facts are secured 
to us by the incidental revelations which 
open up to us on false paths. To these false 
hypotheses we owe most of our knowledge 
and the hypotheses have been laid aside 
as useless scaffolding. Maxwell says in his 
work on "Matter and Motion": "The 
investigations of molecular science have 
proceeded for the most part by the method 
of hypothesis and comparison of the results 
of the hypothesis with the observed facts." 
This is not Baconian doctrine at all. 

It is a typical example of how out of 
absurdities realities emerge. We have thus 
reason \to believe that not only do our 
senseslead us astray as we well know, but 
the_workings of the human mind are impo- 
tent in the face of fundamental cosmic 
facts. It is not for me to speak of the ideas 
of mental philosophy of which I have 



little knowledge and less skill in their 
exposition, but even the casual reader of 
the works of the greatest of them can with 
difficulty come to any other conclusion. 
Locke in many admirable passages in his 
"Essay on the Human Understanding" 
(Our Ideas of Substance) points out that we 
have no clear idea of "substance," a word 
in his day not entirely identical with our 
word matter. Certain attributes of certain 
categories of matter are conveyed to our 
cognition by the senses and from these 
data we form certain ideas or conceptions 
which find lodgment in our minds. So in- 
numerable are they that we unconsciously 
assume there is such a thing as substance 
or substratum or matter which has no 
attributes to appeal to us — the "Being" of 
the Greeks — the "Ding an sich" of Kant — 
but of this, these philosophers say we have 
no assurance supported by observation: 

The same happens concerning the operations 
of the mind, viz.: thinking, reasoning, fearing 
etc., which we concluding not to subsist nor 
apprehending how they can belong to body or 
be produced by it. We are apt to think these 
the actions of some other substance which we 
call spirit. 

Here we find Locke using the word 
"substance" in a manner to include the 
soul as well as the body, the former of which 
we exclude from our word matter. It will 
suffice, however, to make us realize that great 
minds refuse to give credence to the possi- 
bility of forming a basic theory of the 
universe on observation. Theory is not only 
necessary, but it is pure hypothesis or theory 
which is the most necessary. We perceive 
then, that modern physics, no less than an 
ancient cosmology, are built on theories 
impossible of verification, impossible to 
submit to the crucial test of experience. 
We find the modern physicist avowedly 
basing his systems on them despite the fact 
that the modern scientist is repeatedly 
declaring science has nothing to do with 
them. We cannot, then, reject an ancient 



Modern Commentaries on Hippocrates 



41 



cosmology because it is built on unverifiable 
theory, on theory which has since proved 
false, without stultifying modern science, 
which also is founded on a theory incapable 
of verification. Yet out of both, out of the 
ancient as out of the modern cosmology, 
has Truth arisen. 

Hippocrates in his criticism of the Nature 
Philosophers objects to their cosmic theories 
because "there is nothing which can be 
referred to in order to discover the truth, " 
and in lofty scorn the modern scientist, 
standing with both feet on a tortoise un- 
supported by any pinions of fact, declares 
that he has nothing to do with assertions 
which cannot be submitted to the test of 
experiment and observation. Sacrilegious 
though it seems, I confess both Hippocrates 
and the modern scientist and even Socrates 
himself seem to me just a little silly. We 
find both Hippocrates, the ancient scientist, 
and Socrates, the ancient idealist, objecting 
to methods which the Nature Philosophers 
used to open the way to a knowledge of 
the universe. If they did no more, their 
services to science were inestimable in 
postulating cosmic problems whose defini- 
tions still remain intact. Thales and Herac- 
Iitus and Democritus began to divide and 
subdivide: "things above us and things 
below the earth," and the results they 
attained by methods, which Hippocrates 
censured and yet was forced to pursue in 
medicine, constituted the fabric of the 
knowledge of the whole which both he and 
Plato agreed was a prerequisite to a further 
advance. It was as clear to him as it was to 
Plato that without broad and comprehen- 
sive ideas, without a knowledge of the cos- 
mic laws it was idle for the student to begin 
study, either of the human body or of the 
human soul. If this is the implication of 
very many of the passages in Hippocratic 
writings and in Platonic dialogues, we find 
others in which they condemn and ridi- 
cule it. 

Protagoras had from Xenophanes perhaps 



the doctrine that man is the measure of 
all things, discussed in the "Theaetetus" 
of Plato, where much ridicule is thrown 
upon it as the source of knowledge without, 
however, arriving at any clearer idea of 
knowledge. In health a man's wine tastes 
sweet. When he is bilious it tastes bitter. 
How is he, then, to know what its properties 
really are? 

In practice Hippocrates, just like the 
rest of us, seizes on any implement, whatever 
its provenance, which seems useful in prying 
open the lid which hides the secrets of nature 
from us. Occasionally even modern philoso- 
phers, like Maxwell and Bain, 7 in lauding 
the system 0/ Bacon, pause to insist that both 
hypothesis (theory, we used to call it, until 
the word became disreputable) and obser- 
vation are to be used in combination to 
attain the best results. No one can deny 
the necessity of constantly reminding our- 
selves how dangerous it is to become slack 
in attempting to submit theory to the test 
of experience, and this doubtless is the 
animus which moves such minds as Hippoc- 
rates, and many lesser men as well, con- 
stantly to preach this doctrine, though as 
we have repeatedly seen the whole basis 
of science rests on hypothesis which cannot 
be submitted to the test of experience or 
to the exactions of rational thought. 

This is an old song, but, as a distinguished 
advocate of one of the popular modern 
theories of nature remarked to me, it is 
well occasionally to be reminded of it. There 
is less lack of frequent reminders of these 
fundamental limitations, both of observa- 
tion and of thought than of concrete 
criticism, pointing out just where the scien- 
tist violates his principles. I have alluded 
to their conscious trespassing in modern 
physical philosophy. It is not difficult to 
find its unconscious violation by Hippoc- 
rates. In this, it is true, he often places 
himself above the usual pedantry of his 

7 "Education as a Science," by Alexander Bain. 
New York: Appleton & Co., 1901. 



42 



Annals oj Medical History 



predecessors, but he none the less erects 
his own hypotheses, if not on the hot and 
the cold, the dry and the moist, in the 
treatise "On Ancient Medicine" at least 
on the bitter and the sweet, the salt and the 
acid, upon the form of the internal organs 
"best calculated to suck to itself and 
attract humidity from another body." So — 
"when the flatus encounters a broad and 
resisting structure and rushes against such a 
part and this happens when it is by nature 
not strong so as to be able to withstand it 
without pain, not soft and rare, so as to 
receive and yield to it" — remembering how 
much of our own babbling must in time be 
devoid of sense, let us draw a veil over the 
frailties of the human mind which we may 
be sure we shall need more and in a shorter 
time than the Master. If Hippocrates 
exhibited neither error nor tautology, if 
he perceived the ideas of others were no 
more theoretical or hypothetical than some 
of his own, he would be a god, not a man, 
and he is very human. He is a real man; 
he is Hippocrates, the physician, not 
^sculapius, the son of Apollo, and it is 
by his lapses of logic, and his feebleness 
of apperception, not by his immortal genius 
that we recognize him as a father and a 
brother. When he reminds us there are wise 
physicians as well as foolish ones and how 
difficult and laborious the search for truth 
is, how urgent it is for us to know the 
history of the strivings of others after it 
if we are to prosecute wisely our own search 
for it, how impossible it is at best for any- 
one to say one has discovered something 
unknown to one's predecessors, we recog- 
nise the wisdom of the ages, though we often 
forget it. 

It is not clear from the text that the 
author really means to decry such knowl- 
edge, chiefly speculative, as existed in his 
day of anatomy and physiology. It can 
scarcely be denied that if a patient must 
chooseto-day between the anatomical expert 
and him who is ignorant of anatomy but 



experienced in the observation of the sick, he 
would hardly hesitate to prefer the latter. 
If the anatomist derived his knowledge 
from his imagination or even chiefly from 
his speculations, such as we infer was 
chiefly the source from which the Egyptian 
physicians drew the remarkable passages 
on anatomy in the Papyros Ebers s we must 
confess it would be sound judgment. We 
have little reason to suppose more accurate 
anatomical or physiological data existed 
in the days of Hippocrates. At any rate 
we may suspect he has better reason for 
the opinion than appears to us at first 
thought when he declares it is not for the 
Nature Philosophers to teach the physicians 
the origin of nature. It is also not so arrogant 
as it sounds for him to declare that "one 
cannot know anything certain respecting 
'Nature' from any other quarter than from 
medicine." The anatomist of the Papyros 
Ebers and to a certain extent Empedocles 9 
and Alcmaeon, 10 the predecessors of Hippoc- 
rates, drew their ideas of anatomy objec- 
tively not from dissection, but the former 
from the processes of embalming and the 
latter from the sacrifices at the public 
altars, sources open to all, physicians as 
well as laity, and from certain other obser- 
vations and manifest physiological actions. 
The rest was mere subjective theory. All 
was better derivable from even the empirical 
practice of medicine than from any other 

8 "Blight of Theory," by Jonathan Wright, New 
York Medical Journal. 

9 "Diogenes Laertius; Lives and Opinions of 
Eminent Philosophers," tr. by C. D. Yonge. 
London: Henry G. Bohn, 1853. 

10 "Whether his knowledge in this branch of science 
was derived from the dissection of animals or of 
human bodies, is a disputed question, which it is 
difficult to decide. Chalcidius, on whose authority 
the fact rests, merely says (Comment, in Plato, 
'Tim.' p. 363, 3d. Fabr.), 'qui primus exsectionem 
aggredi est ausus.' And the word exsection would 
apply equally well to either case." In "Dictionary 
of Greek and Roman Biography and Mythology," 
edited by William Smith. Vol. i, p. 104. London: 
John Murray, 1870. 



Modern Commentaries on Hippocrates 



43 



calling. Moreover, Nature or cfrvaLs was 
conceived by the Greeks more in the sense 
of what we understand by the processes of 
nature, hence, in this limitation the phys- 
iology of man, rather than in the sense of 
our modern wider conception of the term. 
So Hippocrates was entirely justified his- 
torically in claiming medicine to be the 
teacher of anatomy rather than medicine 
to be the result of the teachings of anatomy 
and physiology. 

Active investigation or research was not 
included in the curriculum; the observation 
of phenomena, even unaided by experi- 
mentation, is still often a safer guide than 
observation controlled by it, and Hippoc- 
rates know no other, though he knew that 
the diaphragm is a broad and expanded 
structure and that "abscesses occur about 
it. There are both within and without the 
body many other kinds of structure, which 
differ much from one another as to suffer- 
ings both in health and disease; such as 
whether the head be small or large; the neck 
slender or thick, long or short; the belly 
long or round; the chest and ribs broad or 
narrow; and many others besides, all which 
you ought to be acquainted with, and their 
differences; so that knowing the causes of 
each, you may make the more accurate 
observations." Thus far he recognized the 
value of anatomy and pathology as an aid 



to observation, and there was but little 
more known, and little more did he know 
of physiology. 

And, as has been formerly stated, one ought 
to be acquainted with the powers of juices, and 
what action each of them has upon man, and 
their alliances towards one another. What I 
say is this : if a sweet juice change to another 
kind, not from any admixture, but because it 
has undergone a mutation within itself; what 
does it first become? — bitter? salt? austere? or 
acid? I think acid. And hence, an acid juice 
is the most improper of all things that can be 
administered in cases in which a sweet juice is 
the most proper. Thus, if one should succeed 
in his investigations of external things, he 
would be the better able always to select the 
best; for that is best which is farthest removed 
from that which is unwholesome. 

The last clauses of the treatise of "On 
Ancient Medicine" but illustrate our ego- 
tistical proverb, implying our own great 
knowledge — "a little learning is a danger- 
ous thing." 

Yet even here, despite the tautology and 
the hypotheses I have quoted, despite much 
more I have not cited from this discourse 
"On Ancient Medicine," we see the Master 
headed in the right direction before hardly 
a path existed. The whole tone of the essay, 
with its inconsistencies and its frailties, 
breathes the spirit of modern medical 
science — better still — of common sense. 



[To be concluded] 



L'AMBULANTEUSE 



Valkyrie is she; on mechanical steed 

Bears wounded warriors from sodden field. 
With flaming exhaust, at extremest speed, 

She rolls to the spot of the greatest yield 
Of the Harvest of Hate. What nobler part 

Could a woman play in the murky hour 
Of the World at War, when the Iight'nings dart 

That betoken the lust of Teutonic power. 



True to tradition and true to herself 

With spirit of Warren and Adams and those 
Who considered a principle greater than pelf 

And would forfeit their lives if occasion arose, 
She too has surrendered the luminous hours 

Of her maidenly years, to travel the trail 
That beckons her spirit from budding bowers 

To sacrifice all in the Quest of the Grail. 

Carleton B. McCulloch, M.D. 
June, 1918. 



A DESCRIPTIVE LIST OF THE INCUNABULA IN THE LIBRARY 
OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA 



The following is a carefully prepared list of the Incunabula in the possession of the Library of the 
College of Physicians of Philadelphia up to May i, 1919. While in no senee a "catalogue raisonne," 
it can properly be called a catalogue, as it is arranged by authors, with more or less description, to 
assist in the identification of the edition or publication. Further, it will be noted that this Library 
follows the ruling of "Hain," and only the books issued in the fifteenth century are classed under 
the head of "Incunabula." 

As a matter of interest to the readers, notes that have been gathered from various sources, are 
appended in a number of cases. No pretense is made that these notes are authoritative, or absolute; they 
are given for what they are worth — mostly the comment of some previous owner. The expert bib- 
liographer is welcome to criticise, deny, or confirm the sayings, as he sees fit. 

Charles Perry Fisher, 

Librarian. 



Abiosus, Joannes. [Dialogus in astrologiae 
defensionem.] [F. ia:] AD INVICTIS- 
SIMVM AC POTENTISSIMVM | 
BELLO ET PRUDENTISSIMUM SI- 
CILIE RE J GEM ALFONSUM. | Dia- 
logus in astrologie defensionem Cnm 
[sic] Uaticinio a diluuio vsq[ue] ad Chri | 
sti annos. 1702. Joannis Abiosi Neapolis 
Regni Ex balneolo mathematica | rum 
professoris Artium [et] Meditine [sic] 
Doctoris. I [Tab. xyl. In fine:] Finit opus 
Dialogi [etc.] Et impressu[m] Uenetijs 
Die. 20 octobris | 1494. Per Magistrum 
Franciscum Lapicidam in contrata Sancte 
Lucie. Ad glo | riam Omnipotentis Dei 
qui assidue benedicatur. | 

37 ff. il. 12 . Venice, Franciscus Lapicida, 1494. 

[Hain no. 24.] 

Only work printed by Lapicida. 

Aegidius Columna. [De regimine princi- 
pum.] [F. 1 a:] () Eorgio miseratione diuina 
Archiepiscopo Ulixponen. Sacro- | sancte. 
Ro. eccesie. tituli sanctoru[m] Petri [et] 
Marcelli presbyte | ro Cardinali Reueren- 
dissimo ac benemerito : Oliuerius Serui | us 
Tholentinus. S. P. D. [F. ib-4 b table of 
chapter-headings.] [F.jja:] Incipit liber de 
regimine p[r]incipu[m] | etc. [In fine:] Ex- 
plicit liber, etc. Impressum Romae per 
inclitufm] viru[m] magistru[m] | Stepha- 



num plannck. de Patauia Anno domi | ni 
Millesimo CCCC LXXXIJ. Die nona Men- 
sis I Maij [et]c. [Register.] 

135 ff. F°. Romae, Plannck, 1482. 

[Hain no. 108.] 
Aegidius Corboliensis, Petrus [or Gilles 
de Corbeil] [Carmina de urinarum judiciis 
cum expositione Gentilis de Fulgineo] 
[F. 1 a:] Carmina de urina[rum] iudiciis 
edit a ab | exceIIe[n]tissimo [domi] no 
m[a]g[ist]ro Egidio cu[m] | co[m]mento 
eiusdem feliciter incipiunt. | [F. 60b:] Hie 
modus imponit[ur] Tractulo [d]e cogno | 
scendis urinis peritissimi magistri Egdii 
cu[m] I exposit[i]o[n]e [et] [com]me[n]to m- 
[a]g[ist]ri Ge[n]tilis [de] fulgineo | su[m]ma 
cu[m] dilige[ntia] pluribfus] i[n] Iocis casti- 
gat[us] a m°. | Auena[n]tio [de] cameri[n]o 
artiu[m] [et] medici[n]e p[ro]fes- | so[r]e 
padueq[ue] i[m]p[r]essus [per] m[a]g[ist]r- 
[u]m matheu[m] Cer | donis [de] uuin- 
dischgrec[z] die 12 iulii. Anno 1483 

64 ff. 4 . Paduae, Mattheus Cerdonis de Win- 
dischgretz, 1483. 

[Hain no. 100.] 

Imperfect, j. 45a blank. 

Aegidius Corboliensis, Petrus [or Gilles 

de Corbeil] [Carmina de urinarum judiciis 

cum expositione Gentilis de Fulgineo] 

[ff. 1— 59 missing.] [F. 76b:] Hie finis im- 



44 



Incunabula 



45 



ponitur tractatulo de cognoscendis v[r]- 
inis [et] pulsu peri- | tissimi magistri 
Egidii cum expositione [et] commento 
magistri Gentilis de | fulgineo summa 
cu[m] diligentia pluribus in Iocis castigatus 
a mag[ist]ro Auenafn] | tio de camerino 
artiu[m] [et] medici[n]e p[ro]fesso[r]e Uene- 
tiis i[m]p[r]essus [per] Benardinu[m] |Ue- 
netu[m] expensis d[e] Jeronymi duranti 
die 1 6 mensis feb[r]uarii 1494 | 

76 ff. 4 . Venetiis, Bernardinus [de Vitalibus] 
for Hieronymus de Durantis, 1494. 

[Hain no. 101.] 

Imperfect, ff. 1-5Q missing. 
Aegidius Corboliensis, Petrus [or Gilles 
de Corbeil] [Carmina de urinarum judiciis 
cum expositione Gentilis de Fulgineo] 
[F. 1 a. tit:] [o]Pus excelle[n]= | tissimi 
magistri Egidij de v[r]inis et pulsu | cum 
expositione clarissimi magistri Gen | tilis 
de fulgineo | [F. ib: vacat.] [F. 2a:] Car- 
mina de v[r]inarum iudicijs edita ab | 
exceIIe[n]tissimo domino magistro Egidio 
cu[m] I commento eiusdem feliciter inci- 
piunt. I [F. 59a :]§ Incipit liber magistri 
Egidij de | pulsibus metrice compositus. 
I [F. 80b:] De significationibus magni | 
pulsus s[e]c[undu]m naturam. | 

[94] ff. 4 . [Lugduni, Martinus Havard, 1499.] 

[Reichling no. 143 1.] 

Imperfect, f. 65 and ff. 8i-Q4 missing. 
Aegidius Corboliensis, Petrus [or Gilles 
de Corbeil] [Liber metricus de pulsibus 
cum commentario Gentilis Fulginatis] 
[F.i a:] Uenantius mutius de camerino. 
Alexandro de bartholaciis de monte 
almi.salutem plurima[m] dicit. *** [F.- 
48a:] §Hic finis imponit[ur] tractatulo 
pulsuu[m] Magistri | Egidii cu[m] co[m]- 
mento Gentilis de Fulgineo qui im | p[r]- 
essus fuit Padue per magistfrum] 
Mattheu[m] cer- | donis de Uuindisch- 
gretz die Januarii Anno | domini 1484. | 

48 ff. 4 . Padue, Mattheus Cerdonis de Win- 
dischgretz, 1484. 

[Hain no. 103.] 
Albertus Magnus. [De generatione et 



corruptione.] [F. ia:] Liber Alberti De 
generatione [et] co[r]ruptione | Incipit 
Liber de generatione [et] co[r]ruptione. 
Cu I ius tractatus p[r]imus est de genera- 
tione [et] co[r]ruptio | ne in co[m]muni 
simpliciter dictis. | [F. 23a:] Imp[r]essum 
Uenetijs per Ioan[n]em [et] G[r]ego[r]iu[m] 
de I G[r]ego[r]ijs fratres. Anno. d[omi]ni.- 
M.cccc.Ixxxxv.die | decima Iunij. | *** 

24 ff. F°. Venetiis, Johannes et Gregorius de 
Gregoriis, 1495. 

[Hain no. 517.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F. ia. tit:] Albertus magnus 
de secretis | mulierum cum commento | 
[F. 2a:] §Expositio super henricufm] de 
sa- I xonia de secretis mulierum In- 1 cipit 
fceliciter. | [F. 56b:] FINIS | §Impressum 
Romse. 1499. | die. 8. Iulii. | *** 

56 ff. 4 . Romae, [Eucharius Silber], 1499 
[Reichling no. 372.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F. ia. tit:] Albertus magnus | 
de secretis mulie | rum et viro[r]u[m]. | 
[F. 33b. 1. 17:] omnium per infinita secula 
secuIo[r]um. Amen. | 

33 ff. 4 . [Augsburg, Johann Froschauer, 1475.] 
[Hain no. 555.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F. ia. tit:] AIbert[us] Magnus 
de secretis mulieru[m] | et viro[r]um | 
[F. 2a:] [S]Cribit ph[iIosoph]us phiIo[s]- 
opho[r]u[m] p[r]inceps. | *** [F. 41b:] Imp- 
[r]essum Iiptzk per MeIchio[r]em | Lotter 
Anno MiIIesimoqui[n]ge[n]tesimo. | 

41 ff. 4°. L[e]iptz[ic]k, Melchior Lotter, 1500. 

[Hain no. 568.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F. ia:] [S]Cribit philosophus 
ph[iIosoph]o[r]um | p[r]inceps su[m]mus. 
*** [F. 83b. 1. 16:] secuIo[r]um Amen. | 

84 ff. 4 . [Ulmae, Johannes Zainer, 1473.] 

[Copinger no. 197.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F. ia. tit:] De fo[r]matio[n]e 
ho[min]is | in vtero materno | *** [F. 53b:] 



46 



Annals of Medical History 



Liber de fo[r] | matione ho = | [F. 54a:] 
minis in vte | ro materno | co[n]gruentis- 
sime inscriptus finit fe | Iiciter ad Iaudefm] 
eius qui hu[n]c mo- | du[m] p[ro]pagandi 
genus humanufm] eide[m] benedicendo 
instituit dicens Cre | scite et multiplicam- 
ini. I 

54 ff. 4 . n. p., n. pub., [circa 1490.] 

[Not in Hain.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F. ia:] [P]HiIosoph[us] ph[iIo- 
soph]o[r]um | p[r]inceps q[ua]rto ethi |- 
co[rum] scribit. *** [F. 45a:] Finis huius 
tractatuli vene- | rabilis Alberti magni. | 
46 ff. 4°. [Argentinae, Hein. Knoblochtzer, 

1480. 
[Hain no. 558.] 

Albertus Magnus. [De secretis mulierum 
et virorum] [F.ia:] [S]Cribit philosophus 
philoso I pho[r]um p[r]inceps. quarto ethi | 
co[r]um homo est optimum *** [F.48a:] 
Alberti magni de secretis mulie | rum 
tractatus feliciter explicit | 

48 ff. 4 . [Antverpiae, Math, van der Goes, 

i486.] 
[Copinger no. 191.] 

Albertus Magnus. [Liber aggregationis 
seu secretorum de virtutibus herbarum, 
etc.] [F.ia.tit:] Liber secreto[r]um Alberti 
magni de virtutibus herba | rum.et ani- 
malium quo[r]undam. Eiusdemq[ue] liber, 
de I mirabilibus mundi.et etiam de qui- 
busda[m] effectibus | causatis a quibus- 
dam animalibus [etc.] | [F.2a:] Liber ag- 
gregationis seu liber secreto[rum] Alberti 
mag I ni de v[ir]tutibus herbaru[m].Iapi- 
du[m].et a[n]i[m]aliu[m] quoru[n]dam | Li- 
ber primus de v[ir]tutibus [q[uo]rundam 
herbarum. | *** [F.i6b.I.26:] §Eiusde[m] 
Alberti magni de mirabilibus mundi | 
feliciter incipit | *** [F.34a:] Imp[r]essum 
Auguste [per] Johanne[m] schauren fe[r]ia 
I secunda post Bartholomei M.CCCC. 
LXXXXVj. I 

34 ff. 4 . Auguste, Johannes Schauren, 1496. 

[Hain no. 542.] 



Albertus Magnus. [Opus de animalibus] 
[F.i a:] Incipit liber Alberti magni ani- 
malium | p[r]imus [qui] est de co[m]muni 
diuersitate a[n]i[m]alium | *** [Ad finem:] 
Finit feliciter opus Alberti magni philoso | 
phi de animalibus: [et] imp[r]essum Man- 
tue per | Paulum Johan[n]is de Butsch- 
bach alamanum Maguntinen[sis] dioce- 
[sis] Sub anno d[omi]ni Mille | simo quad- 
ringentessimo septuagesimonono: die ! 
uero duodecima Januarij *** 

306 ff. F°. Mantue, Paulus Johannes de Butz- 
bach, 1479. 

[Hain no. 546.] 

Imperfect. 2 ff. of table and 1 j. blank missing. 
Albertus Magnus. [Physicorum s. de phy- 
sico auditu Iibri octo. Alberti magni 
Commentaris in octo Iibros Physicorum 
Aristotelis.] [F. ib.] §ExceIIentissimo med- 
ico preclarissimoque philosopho d[omi]no 
Jacobo battifero patri observando. Mat- 
heus I battifero vrbinas artium doctor et 
medicine S. [In fine.] §ExpIicit co[m]men- 
tum Doctoris excellentissimi | Alberti 
magni ordinis predicatorum in Iibros 
phys I icoru[m]. Impressufm] Venetiis per 
Joa[n]nem de forlivio | et Gregoriu[m] 
fratres. Anno d[omi]ni M.CCCC LXXX- 
VIII. die VIII. Januarii. | [Register.] 

168 ff. F°. Venetiis, de Forlivio, 1488. 

[Hain-Copinger 518.] 
Albertus Magnus. [Summa de quatuor 
coaevis et de homine.] [F. ia. tit:] P[r]ima 
Pars Summe | Alberti Magni | De Qua- 
tuo[r] Coequeuis | vna cum secunda | eius 
que est De homine. | [F. 79b. (c. n. 77) :] 
§ExpIicit Liber p[r]ime Partis Su[m]me 
D[omi]ni | Alberti Magni de Quatuo[r] 
coequeuis. | Uenetijs Imp[r]essum per Si- 
monem de Luere | Impensis domini An- 
dree To[r]resani de | Asula. 19 . Me[n]sis 
Decemb[r]is. 1498 . Feliciter. | [F. 81 a. 
(c. n. 79) :] §Incipit liber secunde partis 
summe Alberti Ma- | gni o[r]dinis p[r]- 
edicatorum De homine. | [F. 196b. (c. n. 
194):] § Explicit I Secunda Pars Summe 
AI- 1 berti Magni Ratispanen[sis] Ep- 



Incunabula 



47 



[iscopji De homine. | Uenetijs Imp[re]ssa 
Impe[n]sis d[omi]ni | Andree To[r]resani 
de Asula: arte v[er]o Simo | nis de Iuere. 
xvj° feb[r]uarij. 1498. | Feliciter. | 

197 ff. F°. Venetiis, Simon de Luere for Andreas 
Torresanus de Asula, 1498. 

[Hain no. 569.] 

From the famous Strozzi library. 
Albertus Magnus. [Summa naturalium 
sive opus philosophiae naturalis.] [F. ia:] 
Phia. d. Alberti. M. | [F. 2a:] Illustrissimi 
philosophi & theologf: domini Alberti 
magni co[m]pen | diosum: i[n]signe: ac 
perutile opus Philosophic naturalis : felici- 
ter i[n]cipit. I De acceptione ho[rum] 
nominu[m]: natura & naturale. Cap. I. | 
*** [F. 52a:] Impressum Venetiis per 
Georgium de Arriuabenis: Anno Domini. 
I M.cccclxxxxvi. die ultimo mensis Augus- 
ti. I *** [F. 53b.] Finis. | *** 

54 ff. il. 2 wood-cuts. 4 . Venetiis, Georgius de 
Arrivabenis, 1496. 

[Hain no. 506.] 
Albucasis. [Liber servitoris.] [F. ia:] 
INCIPIT LIBER SERVITORIS LIBER 
I xxviii. Bulchasi[n] Benaberazerin tra[n]- 
slatus a Si | mo[n]e ianue[n]sis i[n]terprete 
Abraa[m] iudeo tortuosie[n]si. | [Djixit ag- 
gregator huius operis: | Postqfuam] ego 
collegi Iibrum hunc | magnu[m] i[n] medi- 
ci[ni]s co[m]positis: q[ui] e[x] liber 
magni iuuamenti: quern | nominaui ii- 
brum seruitorem. | *** [F. 64b. In fine:] 
Finit Seruitoris prepa[ra]t[i]o[n]e medi- 
[cin]ar[um] si[m]pliciu[m] | i[m]- | pressus 
Venetiis p[er] NicoIau[m] Ie[n]so[m] gal- 
Iicu[m]. Mcccclxxi. | 

64 ff. 4 . Venetiis, Nicolaus Jenson, 1471. 

[Copinger no. 3450.] 

First book on pharmacy. A dated Jenson work. 

Only a jew copies known. 

Albucasis. [Liber servitoris de prepara- 

tionibus medicinarum.] [F. 68a:] Liber 

seruito[r]is de p[r]eparac[i]oni | bus medi- 

cina [rum] *** Incipit feliciter. | 

[In- Mesue Damascenus, J. Antidotarium. 
*** circa 1480. ff. 68a-92b.] 

Imperfect, ff. 93-95 missing. 



Alchabitius. [Libellus isagogicus de plane- 
tarum conjunctionibus.] [F. ia. vacat. 
F. ib. Sphaera mundi. F. 2a:] LIBELLVS 
YSAGOGICVS ABDILAZI. IDEST 
SERVI GLO I RIOSI DEI: QVI DICI- 
TVR ALCHABITIVS AD MAGISTE | 
RVM [sic] IVDICIORVM ASTRORVM 
INTERPRETATVS A 10 | ANNE HIS- 
PALENSI SCRIPTVMQVE IN EVN- 
DEM A 10 I HANNE SAXONIE EDI- 
TVM VTILI SERIE CONNEXUM | 
INCIPIVNT. [Term. f. 26b. Deinde f. 27a. 
(c. sign. A.) :] COMENTVM IOHANNIS 
DE SAXO I NIA SVPER TEXTV AL- 
CHABICII. I [In fine:] Finitur scriptum 
super alchabitiu[m] ordinatu[m] Ioa[n]ne- 
[m] de saxonia in | uilla parisiensi anno. 
1331. Correctu[m] per artium & medicinae 
doctorem | domi[n]um Bartholomeum de 
altefm] & nusia. Imp[re]ssum uenetiis 
p[er] Ioa[n]nem | & Gregoriu[m] de for- 
Iiuio fr[atr]em a[n]no salutis. Mcccclxxxxi. 
i[n] die. xxvi. Iulii. | Tabula foliorum 
huius operis. | [quae term, verbo:] FINIS.) 

82 ff. il. 12 . Venetiis, Johannes & Gregorius de 
Gregoriis, 1491. 

[Hain no. 618.] 

Apicius Coelius. [De re culinaria.] [F. ia. 
tit:] Apitii Celii de re Coquinaria Iibri 
decern. | Suetonius Tra[n]quiIIus De Clar- 
is Gra[m]maticis, | Suetonius Tra[n]- | 
quillus De Claris Rhetoribus. | *** [F. 
32b:] Impressum Venetiis per Bernardi- 
num Venetum. | [F. 33a:] C. SVETONII 
TRANQVILLI DE GRAMMA- 1 TICIS: 
ET RHETORIBVS CLARIS LI- 
BELLVS. I *** [F. 40b:] Suetonii Tra- 
[n]q[ui]IIi de claris Gra[m]maticis: & rhe- 
torib[us]. Finis. | 

40 ff. 4 . Venetiis, Bernardinus [de Vitalibus, 

1497.] 
[Hain no. 1282.] 

Ardoynus, Santis. [Liber de venenis] [F. 
1 a:] Incipit liber de venenis quern magis- 
ter santes de ardoy | nis de pe[n]sauro 
*** [ad finem :] Imp[r]essum Venetijs opera 



48 



Annals oj Medical History 



Bernardini ricij de nou- | ria *** M.cccc- 
Ixxxxij. Die. xix. mensis | Julij. *** 

105 ff. F°. Venetiis, Ricius, 1492. 

[Hain no. 1554.] 

de Argelata, Petrus. [Libri sex chirur- 
giae.] [F. ia. tit:] Cirurgia magistri Petri 
de Iargelata. | [F. 2a:] §Incipit liber p[ri]- 
mus Cirurgie magistri petri de Iargelata 

I de bononia artium [et] medicine docto- 
[r]is. I [F. 128b:] P[r]estantissimi artiu[m] 
[et] medicine docto[r]is magistri Pe- | tri 
de Largelata chirurgie finis. | §Venetijs 
ma[n]dato [et] expe[n]sis Nobilis viri 
D[omi]ni Octauia- | ni Scoti Ciuis Modoe- 
tie[n]sis. Octauo kalendas Marti- 1 as. 
1497. Per Bonetu[m] LocateIIu[m] Ber- 
gome[n]sem. | 

131 fF. F°. Venetiis, Bonetus Locatellus for 

Octavianus Scotus, 1497. 
[Hain no. 1637.] 

de Argelata, Petrus. [Libra sex chirur- 
giae] [F. ia. tit:] Cirurgia magistri Petri 
de Iargelata | [F. 2a:] §Incipit liber p[r]- 
imus Cirugie magistri petri de Large | 
lata de bononia artium [et] medicine doc- 
to[r]is. I [F. 131a:] *** Venetijs. 1499. die. 
12. Septemb[r]is. | 

131 ff. F°. Venetiis, n. pub., 1499. 

[Hain no. 1639.] 

Aristoteles. [De natura animalium, etc.-' 
[F. 1 a. tit:] ARISTOTELIS.| De natura 
animalium: libri nouem. | De partibus 
animalium: libri quattuor. | De genera- 
tione animalium: libri quinq[ue]. | IN- 
TERPRETE THEODORO GAZA. | [Ad 
finem:] FINIS. | 

151 ff. F°. n. p., n. pub., [circa 1475.] 

[Hain no. 1698.] 

Aristoteles. [Opera graece.] Venetiis. M. 

II D. Mense iunio Apud Aldum. et hoc 
cum priuilegio. [f. gr. ch. c. f. et (excepto 
primo vol.) c. c. et ff. n. 30 I. Vol. I. 234 
ff. Vol. II. 32 ff. non num. et 268 ff. num. 
Vol. III. 457 ff. num. et 9 ff. non num. 
(c. vacuo). Vol. IV. 519 ff. indicato modo 



num. Vol. V. 316 ff. num., in medio 13 ff. 
non num. et in fine 1 f. non num.] 

5v. F°. Venetiis, Aldus, 1495-1498. 
[Hain no. 1657.] 

First edition. One oj the earliest examples oj 
books printed entirely in Greek characters. 

Aristoteles. [F. ia:] Tractatulus propleu- 
ma= I turn [sic] Aristotelis multas | in 
naturalib[us] questiuncu= | las admira- 
tione dignas | in se continens Iegentibus | 
multu[s] iucundus ac vtilis. | [F. 2a (c. 
sign. Aij) :] §Incipiunt Propleumata Aris- 
totelis. I [F. 35b:] Finiunt Propleumata 
Aristotelis. | Anno domini. M.CCCC- 
xciiiij. I 

[35] ff. 12 . [Leipzig, Kachelofen,] 1494. 

[Hain no. 1732.] 

Arnoldus de Villa Nova. [Breviarium 
practicae medicinae] [F. ia:] b[r]- 
euiariu[m] p[r]atice excelle[n]tissimi Rei- 
naldi | de uillanoua medici *** [F. 100a:] 
Laus deo et suis Sanctis. | 

[12 ms. ff.] & 101 ff. F°. n. p., n. pub., [1475.] 

[Not in Hain.] 

Arnoldus de Villa Nova. [Breviarium 
practicae medicinae] [F. ia. tit:] Practica 
medicine Arnal- | di de Uilla noua. | [F. 
75a:] Uenetijs per Baptistam de to[r]tis. 
M.cccc.xciij I die. xxi. Februarij. | 

76 ff. F°. Venetiis, Baptista de Tortis, 1494. 
[Hain no. 1801.] 

Arnoldus de Villa Nova. [Breviarium 
practicae medicinae] [F. ia. tit:] P[r]actica 
medicine Arnal | di de Uilla noua. | [Ad 
finem:] §Epitoma Medice artis excellen- 
tissimi viri Arnaldi | de villa noua Imp- 
[re]ssum Uenetijs per magistru[m] Otinu- 
[m] I Papiensem de Ia Iuna Anno d[omi]ni. 
M.cccclxxxxvij. I xij. Kal. nouemb[r]is *** 

67 ff. F°. Venetiis, Otinus Papiensis de Luna, 

1497. 

[Hain no. 1802.] 

Arnoldus de Villa Nova. [De arte cog- 
noscendi venena] [F. ia:] TRACT ATVS 
MAGISTRI ARNALDI I DE VILLA 



Incunabula 



49 



NOVA DE ARTE COGNOS | CENDI 
VENENA CVM QVIS TIMET | SIBI 
EA MINISTRARI | [F. 16a:] Et sic est 
finis totius tractatus DEO GRATIAS: | 

16 ff. 4 . [Mantuae, Johann Burster, 1473.] 
[Hain no. 1805.] 

Arnoldus de Villa Nova. [Liber de vinis] 
[F. 1 a:] [HJIenach volget ein Ioblich 
tractat | eins fiirnemen docto[r]s der ertz- 
ney | mitt namen Arnoldi de noua villa 
I *** Wilham vo[n] hirnkofen *** von latin 
zu teutsch tran[s]feriert *** 

11 fF. F°. [Norimbergse, circa 1478.] 

[Copinger no. 655.] 

Arnoldus de Villa Nova. [Regimen sani- 
tatis.] [F. 138a. (c. sign, ti):] Incipit liber 
de co[n]seruatione co[r]pis seu de re |- 
gimine sanitatis co[m]positus p[er] magis- 
tru[m] Arnol | dum de villa noua. | [F. 
1 66b. (c. sign. y$)i\ Explicit regimen 
sanitatis compositum seu o[r]dinatum a 
magistro Arnoldo de villa | noua Cathala- 
no omnium medicorum viuen | tium Gem- 
ma. I 

[In- Salernum, School of. Regimen sanitatis 
Salernitanum. *** circa 1480. ff. I38a-i66b.] 

Arnoldus de Villa Nova. [Regimen sani- 
tatis.] [F. 11b. (c. sign. 08):] Incipit liber 
de conseruatione corporis seu de re |- 
gimine sanitatis composicus [sic] per 
magistrum Arnol | dum de villa noua. | [F. 
135a. (c. sign. r8):] Explicit regimen 
sanitatis compositum seu ordi | natum a 
magistro Arnoldo de villa noua Cathalo 
I no omnium viuentium Gemma. | 

[In- Salernum, School of. Regimen sanitatis 
Salernitanum. *** circa 1480. ff. nib- 135a.] 
[Not in Hain.] 

Arnoldus de Villa Nova. [Regimen sani- 
tatis.] [F. 193b. c. sign. 08:] Incipit liber 
de [con]servatione corporis seu de regi |- 
mine sanitatis compositus per magistrum 
arnoldum de villa noua. | [F. 217a. c. 
sign. r8:] Explicit regimen sanitatis com- 
positum seu ordi[n]a | turn a arnoldo de 



villa noua Cathalono o[m] | nium medi- 
corum viuentium gemma. | 

[In- Salernum, School of. Regimen sanitatis 
Salernitanum. *** circa 1485. ff. I93b-2i7a.] 

Ars memorativa. [F. i a:] Ars memora |- 
tiva Ad com | memorandum] | Terminos 
Questio[n]es Argume[n] [ ta siue Sermones 
quottas:. | [F. 4b:] Imp[r]essum in Ingel- 
stat I Laus deo omnipote[n]tu. | 

[4] ff. il. 12 . [Ingoldstadt, Johann Kachelofen, 

circa 1493.] 
[Not in Hain.] 

[Articella.] [F. i a:] Articella [F. 2a:] 
§Incipiunt isagoge Joannitij ad tegni 
Galieni. P[r]imus | liber medicine. | [F. 
1 86a:] Imp[r]essum Venetijs per Bone- 
tu[m] Locatellum Bergo | mense[m] Iussu 
[et] expensis Nobilis Uiri Octauiani Scoti 
I Ciuis Modoetiensis. Anno Intemerate 
Uirginis par | tus. Nonagesimotertio sup- 
[r]a Millesimum [et] quadrin- | gentesi- 
mum. Tertiodecimo kalendas Januarias. 
Cum I Benedictione Omnipotentis dei 
q[ui] est benedictus In | secula secuIo[r]- 
um. Amen. | 

144 ff. + 51 ff. F°. Venetiis, Bonetus Locatellus 
for Octavianus Scotus, 1493. 

[Hain no. 1872.] 

AUCTORITATES ArISTOTELIS, SeNECE, BOE- 

tii. *** [F. 1 a. tit:] Aucto[r]itates | Aristo- 
telis Senece Boetii Pla- | tonis Apulei 
Affricani [sic] Em-pedoclis Po[r]phirii et | 
Guilberti po[r]ritani. | [Woodcut. F. 68a:] 
§Finit feliciter. [ [2 woodcuts.] [F. 68b. 
Full-page woodcut.] 

68 ff. 24 . n. p., n. pub., [circa 1500.] 

[Not in Hain.] 

Unrecorded work from unknown French press. 
Pellechet describes 16 other editions printed 
at the end of the XVth century. 

Avenzohar, Abhumeron. [Theicrisi dahal- 
modana vahaltadabir c. CoIIiget Avver- 
rois] [F. 1 a. tit:] Abhumeron Abynzoar 
I CoIIiget auerrois | [F. 42b:] §Hierony- 
mus Surianus physicus domini magistri 
Jacobi suriani de Arimino I Artium ac 



50 



Annals oj Medical History 



medicine docto[r]is p[r]eclarissi [sic] fili[us] 
Lecto[r]i Salute[m] plurimam dicit. | *** [F. 
43a:] §Incipit liber de medici[n]a Auer- 
roys: qui dicitur colliget: | *** [F. 102b:] 
*** Imp[r]essum Uenetijs per magistrum 
Otinum papiensem | de Iuna. Anno domi- 
ni nostri iesu ch[r]isti. Mccccxcvij. de | 
cimo kalendas ianuarias. *** 

103 ff. F°. Venetiis, Otinus Papfensis de Luna, 
1497. 

[Hain no. 2188.] 
Avenzohar, Abhumeron. [Theicrisi dahal- 
modana vahaltadabir c. Colliget Aver- 
rois.] [fF. 1-44 wanting.] [F. 45a. tit:[ 
Colliget Auerroys. | [F. 46a. c. sig. a. ij 
et n. 2] Incipit liber de medicina Auerrois: 
I qui dicitur colliget. [etc.] [F. 84. c. n. 40:] 
Explicit liber Auenzoar. | fF. 85-108 want- 
ing.] 

108 fF. F°. [Venetiis, Joannes de Forlivio et 
Gregorius fratres, 1490.] 

[Hain no. 2186.] 

Imperfect, ff. 1-44, 8;-io8 missing. 
Avicenna. [Libri quinque canonis de medi- 
cina et antidotarium] [F. ia:] Liber 
canonis p[r]imus quern p[r]inceps aboali 
I abinsceni de medicina edidit: translatus 
a magistro | Gerardo cremonensi in toleto 
ab arabico in Iatinu[m] | Uerba aboali 
abinseni. | [F. 491a:] Expletus est Iibellus 
de viribus co[r]dis quern | p[r]inceps Aui- 
cen[n]a edidit. Imp[r]essus Venetijs An |- 
no incarnationis Dominice. M.cccclxxxvi. | 

500 fF. 4 . Venetiis, [Petrus Mayfer], i486. 

[Hain no. 2205.] 

Imperfect, ff. 347-446 missing. 
Bagellardus a Flumine, Paulus. [De 
infantium aegritudinibus et remediis.] 
[F. 1 a:] AD Illustrissimum principem 
do I minum NicoIau[m] Tronu[m]. dignis- 
simu[m] | ducem Ueneciarum dominu[m] 
suu[m] p[rae] | cipuu[m]. *** [F. 21b:] Fin- 
it per b[r]eue opusculum de infantiu[m] | 
infirmitatibus remedijs q[ue] ea[rum]. 
Editufm] per egregium ac famosissimum 
artiu[m] [et] | medicine docto[r]e[m] m[a]- 
g[ist]r[u]m Paulufm] bagel | Iardu[m] a 



flumine: [et] imp[re]ssus die. 10. noue[m] 
bris. p[er] p. matheufm] [de] vindisch- 
g[r]etz. 1. 4. 8. 7. I 

22 fF. 4 . [Patavii], Matthaeus [Ceredonis] de 

Windischgretz, 1487. 
[Hain no. 2245.] 

Second edition of first book on diseases of children. 
Bartholomaeus de Pisis. [Epitoma medi- 
cinae.] ff. 1-4 wanting.] [F. 5a. sig. a. 1 :] 
§EPITHOMA MEDICINE BAR- 
THO|LOMEI PHISICI DE PISIS. | 
[Ad finem:] FINIS. | 

104 fF. 4 . [Florentiae, de Morgianis, 1490.] 
[Hain no. 2531.] 

Barzizius, Christoforus [Introductorium 
ad opus practicum medicinae cum com- 
mentariis in IX Almansoriis.] [F. ia. tit:] 
Cristofori Barzizij | Medici singularis in- 
troducto [r] iu [m] P [r] actica eiusdem. | *** 
[F. 256b:] DEO GRATIAS AMEN. | *** 
Imp[r]essit PAPIE i[m]p[r]esso[r]ie artis 
p[er]itissim[is] Ma- | gister Antonius de 
Carchano. Anno salutifero nati | uitatis. 
Mcccclxxxxiiij . die. xx. Augusti Ad Iau- 
de[m] I die [et] eius pie genitricis. | Finis. | 

258 fF. F°. Papiae, Antonius de Carchano, 1494. 

[Hain no. 2666.] 

This edition extremely rare. One of the three 
copies mentioned by Pellechet. 

Basilius. [De invidia.] [F. 34a:] BASILII 
DE INVIDIA. I BASILII ORATIO DE 
INVIDIA E GRAECO IN LATI | NVM 
CONVERSA PER NICOLAVM PER- 
OTVM I INCIPIT. 

[In- Censorinus. De die natali. *** 1497. fF. 
34-36-] 
Basilius. [De Iiberalibus studiis.] [F. 29a 
(c. sign, g):] SANCTI: BASILII: DE: 
LIBERALIBVS: STVDIIS: ET INGE | 
NVIS: MORIBVS: LIBER PER LEON. 
AR EX GRE. IN LA | TINVM CON- 
VERSVS. I 

[In- Censorinus. De die natali. *** 1497. fF. 

29-33-1 

Benedictus, A. [Deobservationeinpestilen- 

tia] [F. 1 a. tit:] De obseruatione in pesti- 

Ientia. | [Eod. f. b:] QVINTII. HAEMY- 



Incunabula 



5i 



LIANI. CIMCRIACI. | POETAE. HEN- 
DECASYLLABICON. | IN. V. LI. 

ALEXANDRI. | PAENTII. AD | LECT. 
[F. 2 et 3. exhib. ep. auct. ad Jac. Con- 
tarenum Patr. Venet., etc. F. 4a tab. 
Eod. f. b. incip. opus, quod est quintus 
liber de febrfbus. In fine:] FINIS. Quinti 
Iibri de febribus | Impressum uenetiis per 
Ioannem & Gregorium de | gregoriis quar- 
to Kale[n]das Augustas. I MCCCCIxxxxiii. 
I Iacobi Co[n]tareni Patricii Venetf: Phi- 
|Iosophi[s] Iurisq[ue] co[n]suItissimi: | Op- 
timis Auspiciis. [Ult. f. b:] Error es sparsim 
coIIecti.| 

27 ff. sm. 4 . Venetiis, per Johannem et Gre- 
gorium de Gregoriis, 1493. 

[Hain no. 807.] 
Bergomensis, Jacobus Philippus [Sup- 
plementum chronicarum.] [F. ia. vacat.] 
[F. ib:] Ad Magistratu[m] Bergomen- 
siu[m]: in omnimoda historia nouissime 
congesta: Giro | nicarum supplementum 
appellata: Prologus. *** Perfectu[m] a[u]t 
p[er] me opus fuit a[n]no salutis n[ost]re. 
1483. 3 . k[a]I[end]as Iu | Iij i[n] ciuitate 
Bergomi: mihi v[er]o a natiuitate quad- 
ragesimo nono. | Impressum autem hoc 
opus i[n] inclita Uenetia[rum] ciuitate: 
per Bernardinu[m] de Benalijs ber | gome- 
sem eode[m] anno. die. 23 . Augusti. | 

116, 180 ff. F°. Venetiis, Bernardinus de Be- 
naliis, 1483. 

[Hain no. 2805.] 

Imperfect. Table, 10 ff. unnumbered, missing. 
First edition. 
Brunschwig, Hieronymus. [Buch von der 
Pest.] [F. 1 a. tit:] Liber pestilentialis de 
venenis epidimie. | Das buch der vergift 
der I pestile[n]tz das da gena[n]t ist der 
gemein sterbent | der Triisen Blatren. 
von Jeronimo b[r]u[n]swig. | [F. 40a:] *** 
Und I das getruckt vnd volendt durch 
mei = I ster Hansen griininger vff mitwoch 
I nach vnser Iieben frowen hymelfart in 
I dem iar als man zalt. 1. 500. iar. | 

40 ff. il. F°. [Strassburg] Johannes Griininger, 
1500. 

[Hain no. 4020.] 



Brunschwig, Hieronymus. [Distillirkunst] 
[F. 1 a. tit:] Liber de arte distillandi. de 
Simplicibus. [ Das Buch der rechten kunst 
I zii distilieren die eintzigefn] ding | *** 
[Ad finem :] *** ge | truckt durch den wol 
geachtefm] Johannem | griieninger zii 
straszburg in dem achte[n] tag | des mey- 
en. Als man zalt von der geburt [ Christi 
fiinfftzehenhundert. Lob sy got. | 

230 ff. il. F°. Strassburg, Johannes Griininger, 

1500. 
[Hain no. 4021.] 

Burley, Walter [De vita et moribus philo- 
sophorum et poetarum.] [F. ia. tit:] 
Uita omniufm] philoso | pho[r]um [et] poe- 
tarum cum aucto[r]itatibus [et] sente[n]- 
tijs I aureis eo[r]undem annexis. | *** [F. 
2a:] Libellus de vita et mo- | ribus philo- 
sopho[r]um et poetarum incipit. | [D]e 
vita et mo[r]ibus phiIosopho[r]u[m] *** [F. 
86b. I. 27:] §Incipit tabula opusculi 
p[re]sentis alphabetica ph[iIosoph]o | rum 
nomina efficatio[r]es q[ue] eo[r]um sen- 
tentias succin = | cte complectens. Jncipit 
feliitcer. [sic] | [F. 95a:] §Laus deo. | 

96 ff. 8°. [Parisiis, Georgius Mittelhus, 1496.] 

[Copinger no. 1389.] 

Burley, Walter [Expositio sive scriptum 
super artem veterem Porphyrii et Aris- 
totelis.] [F. ia:] Pr[a]eclarissimi uiri gual- 
terij burlei anglici | sacre pagine profes- 
soris excelle[n]tissimi supfer] | artem 
ueterem porphyrij et aristotelis ex | positio 
siuescriptu[m] feliciter incipit. | [F. 119a. 
1.30:] Gualterij a[n]glici f[rate]r uilib[is] 
p[re]dicam[en]tis. sex p[ri]n | cipijs et 
porphyrme[n]ijs Ari. op[us] eme[n]datu[m] 
p[er] r[e]ue | re[n]du[m] fratrefm] Sy- 
mone[m] alexa[n]drinu[m] ordi[ni]s p[re] 
I dicato[rum] bachallarium i[m]resu[m] ve- 
netiis p[er] mag[ist]r[u]mxp[ist]o foru[m] 
arnoIdu[m] felicit[er] explicit | [118] ff. 
F°. Venetiis, Christopher Arnold, [circa 
1477]- 

[Hain no. 4127.] 
First edition. 



52 



Annals oj Medical History 



Burley, Walter [Expositio sive scriptum 
super artem veterem Porphyrii et Aris- 
totelis] [F. i a. tit:] Burlei super artem 
veterem | Po[r]phirii et Aristotelis. | [F. 
8ib:] § Explicit scriptum preclarissimi viri 
Gualte | rii Burlei Anglici sacre pagine 
professoris exi | mii. in artem veterem 
Porphyrii [et] Aristote- | lis: Uenetiis Im- 
pressum per Ottinu[m] Papi | ensem. 
Anno salutis. M.ccccxcvii. V. Idus | Maii. 
Regnante inclyto principe Augustino | 
Barbadico. | *** 

82 ff. F°. Venetiis, Otinus Papiensis de Luna, 
1497. 

[Hain no. 4I33-] 

Imperfect, ff. 67-72 and J. 82 blank missing. 
Candidus, Petrus [De hominis genitura] 
[F. 1 a. tit:] Candidus de genitura hominis 
I F. 11b. I. 9:] imp[r]essum Auguste per 
Johannem froschauer. | dum Iegeris ig- 
noscas extere nationi [et] errata castiga- | 
tio. Finis. | 

11 ff. 4°. Augustae, Johannes Froschauer, 
[I493-] 

[Hain no. 4320.] 

Canonicus, Johannes [Quaestiones in VIII 
Iibros. Physicorum Aristotelis.] [F. ia:] 
Joannis Canonici docto[r]is clarissimi o[r]- 
di. I mino[rum] sup[er] octo Iib[r]os phy- 
sicorum] q[uaesti]o[n]es i[n]cipiu[n]t | [F. 
103a:] Q[uaesti]onibus subtilissimis claris- 
simi docto[r]is Jo- | annis canonici ex 
o[r]di[n]e minofrum] o[mn]i cura [et] dili- 
ge[n] I tia venera[n]di fr[atr]is Fra[n]cisci 
de benzonibfus] de ere | ma bacchalarij 
sacre theologie i[n] [con]uentu Uene | 
tiafrum] p[er] i[n]genio adhibita fme[m] 
i[m]posuit Octauianfus] | Scotus de Mo- 
doetia. M.CCCCLXXXI. | 

107 ff. F°. Venetiis, Octavianus Scotus, 1481. 
[Hain no. 4345.] 

Cebes. [Tabula.] [F. 16a:] CEBETIS THE- 
BANI TABVLA: E GRAECO IN | LAT- 
INVM CONVERSA PER LVDOVICVM 
I ODAXIVM PATAVINVMI | 

[In- Censorinus. De die natali. *** 1497. ff. 
16-20.] 



Celsus, Aurelius Cornelius [De medicina 
Iibri octo] [F. 1 a:] AVRELII CORNELII 
CELSI MEDICINAE LIBER PRI- 1 
MUS INCIPIT. I [F. 144b:] Cornelii celsi 
de medicina Liber finit. Impressum Med- 
iolani Per Leo | nardum pachel & Vlder- 
ichum sinczenzeler. diligentissime emenda 
turn. Anno salutis. M.CCCCLXXXI. | 
152 ff. F°. Mediolani, Leonardus Pachel et 

Udalricus Scinzenzeler, 148 1. 
[Hain no. 4836.] 

Celsus, Aurelius Cornelius [De medicina 
Iibri octo.] [F. 1 a:] AVRELII CORNELII 
CELSI MEDICINAE LIBER PRIMVS 
INCIPIT. I [F. 59b:] Cornelii celsi de 
medicina Finis. Impressor Ioannes rubeus 
Vercellensis fuit die viii. | mensis Iulii. 
M.cccc.xciii. Venetiis. | 

62 ff. F°. Venetiis, Joannes Rubeus Vercellen- 
sis, 1493. 
[Hain no. 4837.] 

Celsus, Aurelius Cornelius [De medicina 
Iibri octo.] [F. 1 a. tit:] CORNELIVS 
CELSVS I [F. 2a:] AVRELII CORNELII 
CELSI MEDICINAE LIBER PRIMVS 
IN- I CIPIT I [F. 94a:] Impressum Vene- 
tiis per Philippum pinzi. Sumptibus 
d[omi]ni Benedicti fontana. Anno | 
d[omi]ni. M.ccccxcvii. die. vi. Mai. | 
94 ff. F°. Venetiis, Philippus Pincius for Bene- 

dictus Fontana, 1497. 
[Hain no. 4838.] 

Celsus, Aurelius Cornelius [De medicina 
Iibri octo.] [F. 1 a:] PRIMO LIBRO 
CORNELII CELSI. | DE MEDICINA 
HAEC CONTINENTVR: I *** [F. 7b:] 
FINIT TABVLA. | [F. 8 wanting.] [F. 
9 b:] BARTHOLOMEVS FONTIVS 
SAXETTO SUO. S. | *** [F. 10a:] COR- 
NELII CELSI DE MEDICINA LIBER 
INCIPIT. I *** [F. 196b:] CORNELII 
CELSI DE MEDICI I NA LIBER FIN- 
IT FLOREN I TIAE A NICOLAO IM |- 
PRESSVS ANNO SALVTIS M | CCCC 
L I XXV I III. I 

196 ff. 4°. Florentiae, Nicolao [di Lorenzo], 
1478. 



Incunabula 



53 



[Hain no. 4835.] 

/. A8 blank missing. First edition. 

Censorinus. [De die natali.] [F. ia. tit:] 
Index Iibrorum: qui in hoc uolumine 
continentur. | Censorinus de die natali. | 
Tabula Cebetis. | Dialogus Luciani. | En- 
chiridion Epicteti. I Basilius. | Plutarchus 
de Inuidia & Odio. | [F. ib:] Ad nobilem 
Bartholomeum blanchinum Philippi 
Beroaldi Bon. epistola. | *** [F. 38a:] Im- 
pressum Bononiae per me Benedictum 
hectoris bononie[n]sis adhibita p[er] | uiri- 
bus silertia & diligentia. Anno salutis. 
M.cccclxxxx. vii. quarto idus Maii | IIIus- 
trissimo Io. Bentiuolo. reip. bonon. habe- 
nas foeliciter moderante. | Registrum. | 
[et insign. typogr. c. Iitt. B. f. r. ch. c. f. 
401. 38 ff. c. marginal, et titt. column.] 

38 ff. F°. Bononiae, Benedictus Hectoris, 1497. 

[Hain no. 4847.] 

Cerasianus, Johannes de Monte Regio. 
[Repetitio c. sententiam sanguinis.] [F. 
1 a. tit:] Repetitio famo | sissimi c. Sente- 
[n]tia[rum] sanguinis | bona [et] vtilis 
subti. Ne. cle. vel | mo. in qua plenissime 
[et] pluci- I de tractatur omnis materia 
in I regularitatis Clericis perma | xime 
necessaria. | [F. 56a:] §Repetitu[m] [et] 
resumptufm] est hoc c. Sententiafm] san- 
guinis I *** Imp[r]essumq[ue] p[er] Mel- 
chio I rem Lotter ciuem Liptzen. Anno 
xpi.M.cccc.xcix. | 

56 ff. 4 . Lipsiae, Melchior Lotter for Johannes 
Breitenbach, 1499. 

[Hain no. 3771 and 4880.] 

Cermisonus, Antonius [Consilia medica.] 
[F. 1 a. tit:] Consilia Cermisoni. | Consilia 
gentilis. | Recepte gentilis de feb[r]ibus. 
I Tractatulus de balneis gentilis | Trac- 
tates] de tyriaca Fra[n]cisci caballi. | [F. 
94a:] §Finit liber de animali theria pas- 
tillos theriaca[s]q[ue] confi- | ciente a 
Francisco Caballo B[r]ixiensi viro p[r]e- 
claro: Ue- | netijs editus. Ibidemqfue] im- 
p[r]essus [et]c. 

94 ff. F°. Venetiis, [Bonetus Locatellus for 
Octavianus Scotus, circa 1496.] 

[Hain no. 4884.] 



Champerius, Symphorianus [Practica nova 
in medicina] [F. ia. tit:] P[r]actica noua | 
in medicina. | Aggregate [r] is Iugdune[n]sis 
I domini Simpho[r]iani champerij de om- 
nibus mo[r] I bo[r]um generibus ex tra- 
ditionibus gre= | co[r]um: Iatino[r]um: 
arabu[m] : peno[r]um | ac recentium auc- 
to[r]um: Au | rei Iib[r]i quinqfue]. | Item 
eiusdem aggregato[r]is liber de | omnibus 
generibus feb[r]ium | [F. 149b:] §Finitur 
tractatus de generibus feb[r]ium editus | 
a d[omi]no Simpho[r]iano champerio Lug- 
dunen. IIIu= | strissimi p[r]incipis ducis 
calab[r]ie: Iotho[r]ingie et | barri [et]c. 
p[r]imario physico. | 

155 ff. 4 . [Lyons, n. pub., circa 1500.] 

[Hain no. 4907.] 

[Chiromanthia.] [F. i a. c. sign, ai:] Ex 
diuina phiIosopho[r]um academia: secun- 
dum nature vires ad extra: | chyromanti- 
tio: diligentissime collectum. [In fine:] 
Ex diuina phiIosopho[rum] academia col- 
tecta: chyromantica scientia na- | turalis 
ad dei Iaudem finit. Imp[r]essum Uenetiis 
per magistrum Er- | hardum ratdolt de 
Augusta. I 

25 ff. il. 12 . Venice, Ratdolt, [circa 1480.] 

[Hain-Copinger no. 4971.] 

First edition. 

Compendium sententiarum praeclaris- 
simarum adversus astrologiam. [f.i 
blank. F. 2a:] COMPENDIVM SEN- 
TENTIARVM PRAE | CLARISSI- 
MARVM ADVERSVS | ASTROLO- 
GIAM ET EIVS I FAVTORES. [F. 
2 ib:] Finis. | Impressum Mutinae [per] 
M. Dominicum Rocociolam. | 

[21] ff. 8°. Modena, Rocociola, [circa 1490.] 
[Hain-Copinger no. 5570.] 

de Crescentiis, Petrus [Opus ruralium 
commodorum] [F. ia. tit:] Opus ruralium 
com I modo[r]um Petri de | crescentijs. | 
[Ad finem:] P[r]esens opus ruraliu[m] 
co[m]modo[rum] Pe | tri de crescentijs 
*** imp[r]essum est argentine. | Anno 



54 



Annals oj Medical History 



domini. Mcccclxxxvi. Ffnitum q[ua]n | ta 
feria ante festum sancti Grego[r]ij | 

147 fF. F°. Argentinae, [Johannes Gruninger], 
i486. 

[Hain no. 5831.] 

Culmacher, Philipp von Eger [Regimen 
wider die Pestilenz.] [F. ia. tit:] Regimen 
zu deutsch Magistri | philippi Culmachers 
vo[n] Eger | wider die grausamen ersch- 
[r]ecklichenn Totlichen | pestelentz *** [F. 
26a. 1. 4.] behutten vnd vo[r]warn Amen. | 

26 fF. 4 . n. p., [circa 1480.] 

[Hain no. 5848.] 

Probably the only copy in this country. 

Derrames, Johannes [Carmina de condi- 
tionibus medicinarum solutivarum] [F. 
1 a:] Joannis derrames Cyp[r]ij carmina 
ad eru- | ditu[m] Uatem Petrum paulu[m] 
Barbu[m] de pola | de conditionibus medi- 
cinarum solutiuarum. | [F. 6b:] Finis op- 
ens Die. 4. mensis Julij. 1487. | 

6 fF. 4 . [Paduae, Matthaeus Cerdonis de 
Windischgretz], 1487. 

[Hain no. 6095.] 

[Dialogus creaturarum.] [F. i a:] §Pre- 
fatio in Iib[r]u[m] qui dicitur | dyalogus 
creaturarufm] | mo[r]aIizatus: omni ma- 
terie | mo[r]aIi iocu[n]do [et] edificatiuo 
[sic] I modo applicabilis Incipit | feliciter. 
I [F, 62b:] Presens liber dialogus creatura 
) rum appellatus: iocundis fabulis | ple- 
nus: industria [et] expensis Con | radi de 
hombech incole colonien. | inceptus [et] 
finitus est. Anno domi | ni millesimo q[ua]- 
dringentesimo octo | gesimoprimo me[n]- 
sis octobris die | xxiiii. | 

62 fF. F°. Cologne, Homborch, 1481. 

[Hain no. 6126.] 

Diogenes Cynicus. [Epistolae. Diogenis 
Epistolae interprete Francisco Aretino. 
Bruti et Hippocratis epistolae per Rainu- 
cium traductae.] [F. ia. tit:] Diogenis 
Epistole I Bruti | Yppocratis medici | [F. 
2a:] FRANCISCI ARRETINI ELEGIA 
I ad pium. ii. pontificem maximum | *** 
[F. 54a. I. 4:] FINIS I FLORENTIAE | 



facta est harum epistola | rum impressio 
Per Antonium | Francisci Venetum. Anno 
Domini I M.CCCCLXXXVII X. kalen. 
Iulias I 

54 fF. 4 . Florentiae, Antonius Francisci, 1487. 

[Hain no. 6193.] 

Dioscorides Anazarbeus, Pedacius [De 
materia medica.] [F. ia:] Nota[n]dum 
q[ui] Iibri diasco[r]ides dicti duplex r[e]- 
peritfur] or | dinatio cum eodem tamen 
p[ro]hemio omnio *** [Ad finem:] Explic- 
[it] dyasco[r]ides que[m] petrus | padua- 
ne[n]sis Iegendo co[r]exit [et] expo | nendo 
q[use] vtiIio[r]a su[n]t i[n] Iuce[m] deduxit. 
I Impressus colle p[er] magistru[m] ioh- 
[ann]em | allemanum de medemblick. an- 
no I xpi. millesimo. cccc°. Ixxviij . mense 
I iulij. I 

103 fF. F°. Colle, Johannes de Medemblick, 
1478. 

[Hain no. 6258.] 

First book printed at Colle. 

Dondus Paduanus, Jacobus [Aggregator 
Paduanus de medicinis simplicibus.] [F. 
1 a:] [F]Ructife[rus] medicis actu | rus 
opus: non modo | rudibus tantu[s] & iuue 
I nibus *** [F. ia. col. 2. 11. 52-55:] Opus 
quidefm] hoc Iongis retro | t[ardi]p[ed]ibus 
inchoatu[m] [com]pIetu[m] est p[er] me 
artiu[m] et | medici[n]e docto[r]e[m] 
M[a]g[istrum] Iacobu[m] paduanufm] | 
Anno d[omi]ni. M.ccc. octuagesimo quin- 
to. I [Ad finem :] Tenasmoni Iicinium. hali. 
ibidem | 

286 fF. F°. [Argentinae, Rusch, circa 1470.] 

[Hain no. 6395.] 

Earliest known oj medical incunabula — F. H. 
Garrison. 

Epictetus. [Enchiridion.] [F. 21a. (c. sign, 
e) :] ENCHIRIDION. | ANGELI POLI- 
TIANI IN EPICTETI STOICI EN- 
CHIRIDION E GRAECO A SE IN- 
TERPRETATVM AD LAV | REN- 
TIVM MEDICEM EPISTOLA: | 

[In- Censorinus. De die natali. *** 1497. fF. 
21-28.] 



Incunabula 



55 



Falcutius [Falcucci], Nicolaus [Sermones 
medicinales septem.] 

7 v. in 4. F°. [Papiae et Venetiis, 1484-1491.] 

Sermo 1 — Hain no. n 767. Papiae, Johannes 
Antonius de Businis, 1484. 

Sermo 2 — Not in Hain. Venetiis, Bernardinus 
de Novaria, 1491. 

Sermo 3 — Hain no. 11 768. Venetiis, Bernardi- 
nus de Tridino de Monteferrato, 1490. 

Sermones 4-7 — Hain no. 11768. Venetiis, Ber- 
nardinus de Tridino de Monteferrato, 1491. 



Sermo 1 — De 
Sermo 2 — De 
Sermo 3 — De 
Sermo 4 — De 
Sermo 5 — De 
Sermo 6 — De 
Sermo 7 — De 



Contents 
conservatione sanitatis. 
febribus. 
membris captis. 
membris spiritualibus. 
membris naturalibus. 
membris generationibus. 
cirurgia et de decoratione. 



Falcutius [Falcucci], Nicolaus [Sermones 
medicinales septem.] 

Sermo 5. 294 ff. F°. Papiae, Damianus de 
Comphaloneriis de Binascho, [1484.] 

Contents 
Sermo 5 — De membris naturalibus. 
[Hain no. 11 767.] 

Falcutius [Falcucci], Nicolaus [Sermones 
medicinales septem.] 

Sermo 5. 190 ff. F°. Papiae, Joannes Antonius 
de Birretis et Franciscus de Girardengis, 
1491. 

Contents 
Sermo 5 — De membris naturalibus. 
[Not in Hain.] 

Ficinus Florentinus, Marsilius [Detrip- 
Iici vita]. [F. ia:] §MarsiIius Ficinus 
Florentinus | de triplici vita. | [Printer's 
device.] [F. 136a, explicit apologia, I.20:] 
uitam producendam adhibite moriun- 
tur. I XVI. Septe[m]bris. M.CCCCLXX- 
XVIIII. In agro | Caregio. | [F. 137a (sig. 
A):] Tabula. | CAPITULA PRIMI LIB- 
RI QUI TRA I CTAT DE VITA SANA. 
I [F. 140a. 1. 3. In fine:] rias mundana 
potissimufm] dona. cap. xxvi. | 

139 ff. 16 . [Parisiis, Wolf, circa 1492.] 

[Copinger 2497.] 

Imperfect, j. h$ missing. 



Ficinus Florentinus, Marsilius [Epis- 
tolae] [F. 1 a. tit:] EPISTOLAE MAR |- 
SILII FICINI FLO I RENTINI | [F. 
253b:] Marsilii Ficini Florentini Eloquen- 
tissi I mi Viri Epistolae familiares Per 
Anto- I nium Koberger impraesse Anno 
nincar- | nate deitatis. M.cccc.xcvii.xxiiii. 
febru I arii finiunt Foeliciter. | 

253 ff. 4 . [Norimbergae], Anthonius Koberger, 

1497. 
[Hain no. 7062.] 

Fiera Mantuanus, Baptista [Coena seu 
de cibariorum virtu tibus] [F. ia:] Bap- 
tist[a]e Fiera Mantuani medici Coena. | 
[F. 19a:] Baptistae Fiera Mantuani medi- 
ci Coena : | hie consummata est. Index 
autem sequitur. | 

20 ff. 4 . [Venetiis, Georgius Cristiner de Boll 

circa 1485.] 
[Reichling no. 1 199.] 

Firmicus Maternus, Julius De nativita- 
tibus. [F. 1 a. tit:] Ivlius Firmic[us] | de 
natiuitatibus. | [F. 2a:] §TabuIaLibri Iulii 
Firmici. [F. 4a. col. 2:] §Ioanis Pompeii 
Corniani Brixiani ad Lectorem in Iulium 
Firmicum. [F. 5a:] §lulii Firmici Materni 
Iunioris Siculi Viri Clarissimi ad | Mauor- 
tiu[m] LoIIianum Fascibus Capaniae Ro- 
manae prouin | ciae proco[n]suIem desig- 
natum:***[F. 119a (CXVa):] IVLII 
FIRMICI MATERNI IVNIORIS. V. C. 
MATHESEOS LIBER | SEPTIMVS ET 
VLTIMVS FELICITER EXPLICIT. | 
EPISTOLA. [In fine.] DEO GRATIAS 
IN ETERNVM. I [F. 119b [CXVb):] 
§NicoIaus Amerinus. | §Registrum. | *** 
[In fine:] Impressum Venetiis p[er] Symo- 
nem | papiensem dictum biuilagua. 1 1497. 
die 13 Iunii. | 

3, CXV ff. il. F°. Venetiis, Simon de Bivilauqua, 

1497. 
[Hain no. 71 21 bis.] 
First edition. Has xylographic Gothic title. 

Gaddesden, Joannes [Rosa anglica prac- 
tica medicinae] [F. ia. tit:] Rosa anglica 
p[r]actica me | dicine a capite ad pedes 



56 



Annals of Medical History 



| [F. 2a:] Nicolaus scyllatius siculus mag- 
nifico ac p[rae]stantissimo Amb[r]osio 
varisio rosato ducali phi- | sico ac [con]- 
siliario sapie[n]tissimo. S. D. | [F. 177b:] 
Papie 1492. die. 24. Ianuarij. | Joa[n]ne- 
santonius birreta i[m]p[r]essioni tradidit. | 

177 fF. F°. Papiae, Joannes Antonius Birreta, 
1492. 

[Hain no. 1108.] 

del Garbo, Dinus [Expositio super tertia 
et quarta et parte quinte Fen Avicennae] 
[F. 1 a. tit:] Expositio Dini Flo [rjentini su- 
per ter = I tia [et] quarta [et] parte qui[n]te 
Fen quar= | ti canonis Auice[n]ne cum 
textu. I Ge[n]tilis de fulgineo sup[er] trac- 
tatu de Iep[r]a. | Gentilis de flo[r]e[n]tia 
super tractatibus | de dislocationibus [et] 
fracturis. | Tractatus Dinidepo[n]derib[us] 
[et] me[n]suris. | Eiusdem de emplastris 
[et] vnguentis. | [F. 162a:] Imp[r]essa 
Uenetijs co[m]missione [et] expensis p[ro]- 
uidi viri do | mini Andree de To[r]resano 
de Asula: p[er]. M. Johannem | Hertzog 
alemanum de Landaw. Anno salutis domi- 
ni: I 1499. die vero Decemb[r]is. 4. | 

162 ff. F°. Venetiis, Johannes Hamman de 
Landovia for Andreas Torresanus de Asula, 
1499. 

[Hain no. 6168.] 

Gazi, Antonio [Corona florida medicinae 
sive de conservatione sanitatis.] [F. ia.tit:] 
DE CONSERVATIONE SANITATIS. 
I [F. 2a:] Incipit tabula CapituIoru[m] 
Iibri huius solemnissimi | qui Corona 
Florida Medicinae: siue Conseruatio | 
sanitatis: intitulatur. | [F. 123b:] Impres- 
sum uenetiis per Iohannem de forliuio 
& I Gregorium fratres Anno salutis. 
M.cccclxxxxi. die | xx. me[n]sis Iunii. | 

123 fF. F°. Venetiis, Johannes & Gregorius 

Forlivio, 1491. 
[Hain no. 7501.] 

Geber, Abou Moussah Djafar Al Sali 
[Summa perfectionis magisterii, liber 
trium verborum, Epistola Alexandri M. 
Geberi lib. investigationis magisterii, car- 



mina Iat. et Fr. de Asculo, Fratris Eliae 
et anonymi carmina ital.] [F. ia:] IN- 
CIPIT LIBER GEBER. | Capitulum 
Primum. [ [F. 114a:] Explicit liber Geber 
foeliciter. | 

122 ff. 4°. [Venetiis, circa 1475.] 

[Hain no. 7505.] 

Imperfect, f. 56 missing. 

Gentilis de Fulgineo. [Consilia] [F. ia:] 
Incipiunt co[n]siIia peregregia clarissimi | 
[et] toto o[r]be medici. Celeb[r]atissimi 
gen I tilis de fulgineo. P[rimu]m con- 
silium] p[r]o uno me | Iancolico. | [F. 47a:] 
Finit. Laus deo. | 

47 ff. F°. [Papiae, Hieronymus de Durantibus, 

circa 1480.] 
[Hain no. 7574-] 

Gentilis de Fulgineo. [De proportionibus 
medicinarum] [F. ia:] [G]Racia Iucidio- 
[r]is habitus quern mesue denotat in 
mo [ dis [et] p[ro]po[r]tionibus medicina- 
[rum] que inuice[m] [con]fici debe[n]t | 
*** [F. 10b:] Explicit tractatus Gentilis 
de fulgineo. de p[r]oporcionib[us] me | 
dicinarum *** 

10 ff. 4 . [Patavii, Matthaeus Cerdonis de 

Windischgretz, circa 1480.] 
[Hain no. 7569.] 

Gentilis de Fulgineo. [Super quinto can- 
onis A vincennae] [F. ia:] Incipit sole [m]ne 
[et] fidele scriptu[m] ge[n]tilis | de ful- 
gineo. supfer] qui[n]to canonis. Auicene. 
I [F. 52b:] Hie finitur singularis expositio 
claris | simi docto[r]is Gentilis de Fulgineo 
super I quinto canonis Auicene *** Im- 
pensa Ie | ronimi de dura[n]tibus im- 
pressa. | Explicit. Laus deo. | 

52 ff. F°. [Papiae], Hieronymus de Durantibus, 
[circa 1485.] 

[Hain no. 7568.] 

Gerson, Johannes. [De cognitione casti- 
tatis et pollutionibus diurnis, etc.] [F. ia:] 
Incipit tractatus venerabil[is] m[a]g[ist]ri 
Iohan[nis] | Gerson Cancellarij parisien- 
[sis] de cognicione | castitatis et pollu- 
cionibus diurnis. | [F. 14a:] Explicit trac- 



Incunabula 



57 



tatulus vene[r]abilis magistri | Ioh[ann]is. 
gerson de pollutionibus diurnis. | [F. 14b:] 
Incipft fo[r]ma absoIuc[i]onis sacramental- 
[is] I eiusdem Magistri Ioha[n]nis Ger- 
son. I [F. 16b:] Explicit fo[r]ma absolu- 
c[i]o[n]is sacrame[n]talis ve | nerabilis 
M[a]g[ist]ri Iohfannis] Gerson. deo Iaus. | 

16 ff. 4 . [Cologne, Ulrich Zell, circa 1470.] 

[Hain no. 7691.] 

Gerson, Johannes [De pollutione noc- 
turna, an impediat celebrantem vel non.] 
[F. 2a:] Incipit Tractatulus venerabilis 
M[a]g[ist]ri | Joh[annis] Ger[son] ca[n]- 
cellarij parisien[sis] tracta[tu]s de pollu | 
c[i]o[n]e noctu[r]na. an impediat cele- 
brantem vel no[n]. | [F. 16b:] Explicit 
Tractatulus venerabilis Magistri | Iohan- 
nis Gerson de pollutione nocturna | An 
impediat celebrantem? An non? | 

16 ff. 4°. [Cologne, Ulrich Zell, circa 1472-1473.] 

[Hain no. 7695.] 

Rare edition, jrom the first press at Cologne. 

Gilinus, Corradinus [De morbo quern 
Gallicum] [F. ia:] Co[r]adinus gilinus arc- 
tium [et] medicinae docto[r] de mo[r]bo 
quem | gallicum nuncupant ad Illustris- 
simum. D. sigismundu[m] esten. | [Ad 
finem:] Finis. | 

4 ff. 4 . n. p., n. pub., [circa 1497.] 

[Not in Hain.] 

Glanvil, Bartholomaeus [De proprietati- 
bus rerum]. [F. ia:] §Incipiu[n]t tituli 
Iib[r]o- I ru[m] capituIo[rum] venerabil[is] 
bar I tholomei anglici de p[r]op[r]ieta | 
tibus re[rum]. [F. 11a:] Incipit p[ro]- 
hemiu[m] de p[r]op[r]ietatib[us] re[rum 
fratris | Bartholomei anglici de o[r]dine 
frat[rum] mino[rum] | [F. 456b:] Explicit 
tractatus de p[r]op[r]ietatibus refrum] edi- 
t[us] I *** §Impressus per me Joha[n]nem 
koelhofF de Iubeck Colonie ciuem. Anno 
natiuitatis | domini. Mcccclxxxi | 

483 ff. 4 . Coloniae, Joannes Koelhoff, 148 1. 
[Hain-Copinger no. 2501.] 

Glanvil, Bartholomaeus [De proprieta- 
tibus rerum] [F. ia:] Incipiu[n]t tituli | 
Iib[r]o[rum] et capituIo[r]u[m] venerabilis 



I Bartholomei anglici de p[r]op[r]i | etati- 
bus reru[m]. [Ad finem:] *** Imp[r]essus 
per industrio- | sum viru[m] Anthoniu[m] 
koburger indite Nuren- | berge ciuefm]. 
Anno salutis gratie. M.cccclxxxiij. | iij. 
kal[enda]s. Iunij. | 

266 ff. F°. Norimbergae, Anthonius Koburger, 
1483. 

[Hain no. 2505.] 

Glanvil, Bartholomaeus [De proprieta- 
tibus rerum] [F. ia. tit:] Liber de p[r]o- 
p[r]ietati | bus rerum Bartholo | mei an- 
glici I [Ad finem:] *** Imp[r]essus Argen- 
tine I Anno d[omi]ni. M.cccc.Ixxxv. Fini- 
tus in die san | cti Ualentini. | 

300 ff. F°. Argentinae, n. pub., 1485. 

[Hain no. 2506.] 

Glanvil, Bartholomaeus [De proprieta- 
tibus rerum] [F. ia. tit:] P[r]oprietates 
Rerum do= | mini bartholomei anglici 
I [Ad finem:] Explicit liber de p[ro]p[r]ie- 
tatibus rerum | editus a fratre Bartholo- 
meo anglico o[r] | dinis fratrum mino- 
[r]um. Anno domini | Mcccclxxxviij. 
kale[n]das vero Iunij. xij. | 

326 ff. F°. [Argentinae, Joh. Priiss], 1488. 

[Hain no. 2507.] 

de Gordon, Bernard [Practica dicta Iilium 
medicinae] [F. 1 blank wanting.] [F. 2a:] 
Cy co[m]mence Ia p[r]atique de tressex | 
cellent docteur [et] maistre en medeci = 
I ne Maistre Bernard de Go[r]don | qui 
sappelle fleur de Iys en medecine | [Ad 
finem:] Et imp[r]ime a Iyon Ian mil. cccc- 
xcv. I Ie dernier iour daoust. | Deo gra- 
tias. I 

247 ff. F°. Lyon, 1495. 

[Hain no. 7801.] 

First and only edition in French in the 15th 
century. 

de Gordon, Bernard [Practica dicta Iilium 
medicinae] [F. 1 blank wanting.] [F. 2a:] 
In nomine dei miserico[r]dis incipit | 
p[r]actica excelle[n]tissimi medicine monar 
I ce domini magistri Bernardi de Go[r] = 
I donio dicta Lilium medicine. | [F. 205b:] 
Imp[r]essa Lugduni per Anthoniu[m] 



58 



Annals of Medical History 



Ia[m]bil | Iionis [et] Marinu[m] sarraceni: 
co[n]socio[r]um | Anno d[omi]ni. 1491. die 
2. maij. Ad Iaudem | o[mn]ipote[n]tis dei 
tociusqfue] curie celestis. ame[n]. | *** 

206 ff. F°. Lugduni, Anthonius Larabillion et 
Marinus Saracenus, 1491. 

[Ham no. 7797.] 

de Gorinchem, Henricus [Tractatus de 
superstitiosis]. [F. ia:] Incipit tractatus 
de sup[er]sticiosis | quibusda[m] casibfus] 
[com]piIat[us] in alma vniue[r]sitate studij 
CoIoniens[is] p[er] | ven[er]abilem m[a]g- 
[ist]r[e]m Heinricu[m] de | Gorihem. *** 
[F. 1 8b:] Explicit Tractatus cui[us] sup[r]a 
I de CeIeb[r]at[i]one festo[rum]. | 

18 ff. 8°. [Esslingae, Conr. Fyner, 1472.] 

[Hain-Copinger no. 7807.] 

Gorus, Joannes de Sancto Geminiano 
[Summa de exemplis et similitudinibus 
rerum.] [F. ia. tit:] Summa de Exemplis 
Ac I similitudinibus reru[m] | Nouiter im |- 
p[r]essa | [Ad finem:] Imp[r]essum aut[em] 
Uenetijs Ioa[n]ne[m] [et] G[r]egorium de 
G[r]ego[r]ijs fratres. | Mcccclxxxxvij. die. 
x. Ap[r]ilis. I FINIS. | 

404 ff. 4°. Venetiis, Johannes et Gregorius de 
Gregoriis, 1497. 

[Hain no. 7545.] 

Gorus, Joannes de Sancto Geminiano 
[Summa de exemplis et similitudinibus 
rerum.] [F. ia. tit:] Summa magistri 
Ioha[n]nis | de sancto Geminiano ordi | nis 
fratru[m] predicato[rum] de ex | emplis 
[et] si[mi]Iitudinibus re[rum] [F. ib:] Cla- 
rissimo theologo sacratissimi dei studij 
expositori magistro Michael wildeck: | 
*** [F. 342a:] Explicit summa magistri 
Iohannis de sancto Geminiano ordinis 
predicato[rum] in | signis [et] p[er]utilis : 
de exemplis [et] similitudi | nibus rerum: 
Impressa per magistros Io | hannem Petri 
de Langendorff [et] Iohan | nem froben 
de Hammelburg Basilien[sis]. vr | bis ciues 
Anno domini. M.cccc.xcix. in | die conuer- 
sionis sancti Pauli. 

342 ff. 8°. Basileae, Joannes Froben de Ham- 
melburg, 1499. 

[Hain no. 7546.] 



de Gradi, Joannes Matthaeus Ferrarius 
[Expositiones super tractatum de urinis 
et vigesimam secundam Fen tertii canonis 
Avicennae] [F. 1 blank wanting.] [F. 2a:] 
Incipiunt magist[r]i Ioannis Mathei ex 
ferrarijs | de gradi Expositio[n]es super 
tractatufm] de vrinis [et] | vigessimam- 
secundam fen tercij canonis domini | Aui- 
cene: sup[er] quam nullus ante ipsum 
sc[r]ipsit. I [F. 39b:] Imp[r]essum Medio- 
Iani per Iacobufm] de San | cto Nazario 
de Rippa a[n]no d[omi]ni. M.cccclxxxxiiij 
I Die. xxvi. mensis Iulij. | 

40 ff. F°. Mediolani, Jacobus de Sancto Nazario 

de Ia Ripa, 1494. 
[Hain no. 7839.] 

de Gradi, Joannes Matthaeus Ferrarius 
[Expositiones super vigesimam secundam 
Fen tertii canonis Avicennae] [F. ia (c. 
sig. a. 2):] Expositiones p[ra]eclarissimi 
[et] subtilissimi Ma | gistri Jo. Mathei ex 
ferrarijs [de] gradi. supfer] vigessi | mam- 
secu[n]da[m] Fen. tertij canonis. d. Auic. 
ad IIIu I strissimum Ducem *** [F. 103a. 
col. 2:] Imp[r]essum Mediolani Su[m]mo 
studio [et] dili | gentia per Iacobu[m] de 
s[an]c[t]o Nazario de Ia Ripa | Anno. M.- 
ccccxciiij. die. xvij. nouemb[r]is, | 

103 ff. F°. Mediolani, Jacobus de Sancto 
Nazario de Ia Ripa, 1494. 

[Hain no. 7840.] 

Grassi, Beneventus [De oculis eorumque 
aegritudinibus et curis.] [F. ia:] BENE- 
VENVTI GRASSI HIE | ROSOLIMI- 
TANI DOCTORIS | CELEBERRIMI 
AC EXPERTIS I SIMI DE OCVLIS 
EORVMQVE I EGRITVDINIBVS & 
CVRIS FE I LICITER INCIPIT. | [Ad 
finem:] SEVER. FERRAR. | F F. IIII. | 
35 ff. 4 . [Ferrariae], Sever[inus] Ferrarfiensis], 

[1474.] 
[Hain no. 7869.] 

First edition of the first book printed on the 
diseases of the eye. 

Grunpeck de Burckhausen, Joseph 
[Tractatus de pestilentiali scorra sive 
mala de Franzos.] F. ia. tit:] §Tractatus 
de pestilentiali Sco[r]ra siue mala de 



Incunabula 



59 



Franzos. | 0[r]igfnem. Remedfaq[ue] eius- 
dem continens, co[m]piIatus a vene | 
rabili viro Magistro Ioseph G[r]unpeck 
de Burckhausen. | sup[er] Carmina que- 
dam Sebastiani B[r]ant vtriusq[ue] iuris 
p[r]o | fesso[r]is. | 

12 ff. il. 4 . [Augustae, Johannes Froschauer, 
1496.] 

[Hain no. 8091.] 

Grunpeck de Burckhausen, Joseph 
[Tractatus de pestilentiali scorra sive 
mala de Franzos.] [F. ia. tit:] Tractatus 
de pestilentfa | Ii Sco[r]ra siue mala de 
Franczos 0[r]igine[m]. Remediaq[ue] | 
eiusdem continens. co[m]piIatus a venera- 
bili viro Magi= | stro Ioseph Grunpeck 
de Burckhausen sup[er] carmina queda[m] 
Sebastiani B[r]ant vtriusqfue] iuris p[r]o- 
fesso[r]is: | Sco[r]ra de Franssois | [F. 12a:] 
AME| 

12 ff. il. 4 . [Coloniae, Cornells de Zierikzee, 

circa 1497.] 
[Hain no. 8092.] 

Guainerius, Antonius [Opera.] [F. 1 blank.] 
[F. 2a:] Incipit tractatus de egritudinibus 
I capitis, editus per Magistrum An |- 
tonium Guaynerium Artiu[m] [et] medi- 
ci[n]e I doctorem papiensem. | [F. 352b:] 
In hoc uolumine agregati sunt o[mn]es | 
tractatus *** studio papie[n]si et antonij 
de ca[r]cano o [ pera papie i[m]pressa 
a[n]no a natali domini | i. 4. Ixxx.i. *** 
[F. 354 wanting.] 

354 ff. F°. Papiae, Antonius de Carcano, 148 1. 

[Hain no. 8097.] 

Imperfect, ff. 342-353 mutilated. 

Guy de Chauliac. [Chirurgia cum aliorum 
tractatibus de eadem materia] [F. ia. tit:] 
Cyrurgia parua Guidonis | Cyrurgia Albu- 
casis cu[m] caute- | rijs [et] alijs instru- 
ments. I Tractatus de oculis Iesu hali | 
Tractatus de oculis. Canamusali | [Ad 
finem:] § Explicit liber de curis omnium 
passionum ocuIo[rum] que[m] | fecit [et] 
composuit Canamusali philosophus De 
Baldach. | Uenetijs per Bonetum Locatel- 



Ium p[r]esbyteru[m] Ma[n]- | dato [et] 
sumptibus heredu[m] quonda[m] Nobilis 
viri domini | Octauiani Scoti Modoetie[n]- 
sis. Anno d[omi]ni. M.CCCCC. | sexto 
Kal. Feb[r]uarias. | 

68 ff. il. F°. Venetiis, Bonetus Locatellus for 

Octavianus Scotus, 1500. 
[Hain no. 4813.] 

Guy de Chauliac. [Opera chirurgica.] [F. 
1 blank wanting.] [F. 2a:] Nel nome de 
dio co[m]me[n]za Io inue[n]tario | ouer 
colectorio che apartie[n] ala parte d[e] j Ia 
cirogia: co[m]posto e compido del a[n]no | 
de Ia incarnation del nostro signore | 
Mccc.Ixiii. p[er] Io clarissimo e famoso do | 
tor maistro. Guidon de gualiaco ciroi | co 
i[n] Io cIarissi[m]o studio de mompolier. | 
[F. 239b:] Finisse Ia clarissima opera |*** 
Et impresso per maistro Ni- | colo girar- 
dengho de noue: In uene | sia nel. Mcccc- 
Ixxx. adi do del mese | de nouembro. *** 

240 ff. F°. Venetiis, Nicolaus Girardengis de 

Novis, 1480. 
[Copinger no. 1548.] 

Haly Abbas. [Liber regalis dispositio nomi- 
natus ex arabico] [F. 6a:] Liber p[r]imus | 
In nomine su[m]mi dei qui cu[m] trinus 
sit personis vnus est | ***[F. 191b:] Im- 
p[r]essum venetijs. die 25. septe[m]b[r]is. 
1492. op[er]a bernar- | dini ricij de nouaria. 
i[m]pensa vero excelle[n]tissimi artiu[m] 
[et] medi- |cine docto[r]is d[omi]ni mag- 
[ist]ri Ioannis d[omi]nici de nigro *** 

192 ff. F°. Venetiis, Bernardinus Ricius de 
Novaria for Johannes Dominici de Nigro, 
1492. 

[Hain no. 8350.] 

Harderwyck, Gerardus [Epitomata seu 
reparationes totius philosophiae natur- 
alis.] [F. 1 a. tit:] In epitomata to | tius 
naturalis ph[iIosoph]ie que trito sermone 
rep[ar]at[i]o[n]es appellantur | Alberto 
centonas [con]tinentia. in bursa Lauren- 
tiana fIo[r]en | tissimi Agrippinensis gym- 
nasij castigatissime edita epigra[m] | ma 
ad Iectorem: [F. 339b:] § *** scriptis con- 



6o 



Annals oj Medical History 



fo[r]mia per Magistru[m] gerardum her- 
derwiccensem *** et *** Burselaurencij *** 
emendatissime ad vtilitatem | o[mn]i[u]m 
textu[m] Aresto teles [sic] intel | Iigere 
cupie[n]tium eIabo[r]ata. et per honestum 
viru[m] Henricum | quentel Coloniensem 
ciue[m] nitidissime *** Anno *** Millesi- 
mo quadringe[n]tessimo sup[er] nonagesi 
| mum sexto p[r]edie calendas martias *** 
§TeIos totius operis multis retro tempo[r]i- 
b[us] a [ studentibus Iiberaliu[m] artium 
desiderati. | 

3 v. in i. 340 ff. 3 por. 12 . Coloniae, Henricus 

Quentell, 1496. 
[Hain no. 8362.] 
First edition. 

Henricus de Saxonia. [Libellus de secretis 
mulierum] [F. ia. tit:] Tractatus Hein | 
rici de Saxonia Alberti magni discipuli 
I de secretis mulierum. | [F. 76a:] Explicit 
tractatus Heinrici de Saxonia AI | berti 
magni discipuli de secretis mulierum 
Im I p[r]essus Auguste Per Anthonium 
So[r]g feria | sexta post Bonifacij Anno 
salutis Millesi- | moquad[r]ingentesimooc- 
tuagesimonono. | 

76 ff. 4 . Augustae, Anthonius Sorg, 1489. 
[Hain no. 8434.] 

Hentisberus, Guilelmus. [Expositio reg- 
ularum solvendi sophismata.] [F. 2a (c. sig. 
a 2 ) :] [ ] Egulas soluendi sophismata. 
*** [F. 58b. I.24:] Finis egredij hentisberi 
regula[rum] [et] sophismatufm] | expo- 
[sitio]nis p[er] eximiu[m] sophismata[m] 
[et] philosophufm] su[m]mu[m] [ magis- 
tru[m] gayetanu[m] de tienis emendate 
p[er] acutis | simu[m] artiufm] ac medicine 
doctore[m]. m. Franciscum | agubiense[m] 
mane medicine theorica[m] papie Ieg- 
e[n]te[m] | su[m]ma cu[m] diligentia p[er] 
me andreafm] de bonetis d[e] pa | pia 
venetiis i[m]presse. *** M.cccclxxxiij die. 
ix. d[e]ce[m]bris. Laus deo et beate vir- 
gini. I Registrum | *** FINIS. | [58] ff. 
F°. Venetiis, de Bonetis, 1483. 
[Hain-Copinger 8441.] 



Hermes Trismegistus. Liber de potestate 
et sapientia dei. [F. ia. (c. sign, a) tit.:] 
MERCVRII TRISMEGISTI LIBER 
DE POTESTA|TE ET SAPIENTIA 
DEI PER MARSILIVM FICI | NVM 
TRADVCTVS: AD COSMVM MEDI- 
CEM. I [F. 32a:] FINIS EST OPERIS 
ELEGANTISSIMI | MERCVRII TRIS- 
MEGISTI I Mercurii Trismegisti per 
Marsilium Ticinum [sic] Florentinum e | 
graeco in Iatinum Traducti Finis. | Vene- 
tiis per Damianum de Mediolano. | 
M.CCCCLXXXXIII. die. x. Maii. | 

[32] ff. 8°. Venetiis, Damianus de Mediolano, 
1483- 

[Hain no. 8461.] 

Hippocrates. [Libellus de medicorum as- 
trologia.] [F. 45b:] Hyppocratis libellus 
de medico[r]u[m] astrologia incipit: | a 
Petro de abbano in Iatinu[m] traductus. 
I [F. 49a:] Hyppocratis libellus de medi- 
co [r]u[m] I astrologia finit: a Petro . de 
abbano | in Iatinufm] traduct[us] Imp[r]es- 
sus est arte ac diligentia mira Erhardi 
Rat- I dolt de Augusta Imperante inclyto 
Johanne Mocenico duce Uene- | to[r]u[m] : 
Anno salutifere incarnationis. 1485. | 
Uenetijs | 

[In- Prognosticon de mutatione aeris. *** 1485. 
ff. 45b-49a.] 

[Hortus sanitatis.] [F. i a. tit:] Herbarius 
zu teiit I sche vnd von aller handt kreti- 
teren. | [F. 261b:] §Ged[r]uckt vnd saligk- 
Iich vol- I Iendet dyser Herbarius [d]urch 
I Hannsen Schonsperger in der | Keyser- 
Iichen stat Augspurg an | dem afftermon- 
tag nach Tybur | cij. Nach Cristi geburt 
tausent | vierhundert vnnd in dem d[r]eu 
undeneuntzigsten jare. | 

261 ff. F°. Augustae, Johannes Schonsperger, 
1493- 

[Hain no. 8954.] 

[Hortus sanitatis] [F. ia:] Ortus Sanitatis. 
I De herbis et plantis | De animalibus [et] 
reptilibus | De Auibus et volatilibus | De 
piscibus [et] natatilibus | De Lapidibus 



Incunabula 



61 



[et] in terre uenis nasce[n] | (tibus | De 
Urinis et ea[rum] specfebus | Tabula medi- 
cinalis Cum directo | rio generali per 
omnes tractatus. | [F. 342b:] Hec Aui- 
cenna. Egidius. Isaac. [et]c. Et hec de | 
v[r]inis dicta sufficiant. §Finis. | 

360 ff. il. F°. [Argentinae, Johannes Priiss, 

circa 1498.] 
[Hain no. 8943.] 
Imperfect. Part of title supplied by hand. ff. 

188, 208 & 333 missing. 

[Hortus sanitatis] [F. i a. tit:] Ortus Sani- 
tatis I De herbis et plantis. | De Animali- 
bus [et] reptilibus | De Auibus et volatili- 
bus I De Piscibus [et] natatilibus | De 
Lapidibus [et] in terre venis nascefn] | 
(tibus I De Urinis et ea[rum] speciebus | 
Tabula medicinalis Cum directo | rio gen- 
erali per omnes tractatus. [ [F. 342b :] Hec 
Auicenna: Edidius: Isaac [et]c. Et hec de 
v[r]i I nis dicta sufficiant. Finis. | [F. 343a- 
360a. Tabulae] 

360 ff. il. 3 pi. F°. [Argentinae, Johannes Priiss, 

circa 1490.] 
[Hain no. 8941.] 
Imperfect, ff. 10 &" 333 missing. 

Hugo Senensis. [Super aphorismos Hippo- 
cratis et super commentum Galeni.] [F. 
1 a. tit:] Expositio Ugonis Senensis super 
apho-| rismos Hypocratis [et] super co [mo- 
mentum I Galieni eius interp[r]etis. | [F. 
159b:] §Uenetijs imp[r]essu[m] ma[n]dato 
[et] sumptibus Nobilis vi- | ri domini 
Octauiani Scoti Ciuis Modoetiensis. Deci- 
[m]o I kalendas Junias. 1498. per Bonetum 
Locatellum Ber | gomensem. | 

160 ff. F°. Venetiis, Bonetus Locatellus for 

Octavianus Scotus, 1498. 
[Hain no. 9012.] 

Isaac Judaeus. [Tractatus particularibus 
diaetis.] [F. 2a:] Eximij Isaac medicine 
monarce: de p[ar] | ticularibus dietis libel- 
ous] *** [F. 59a:] Hie tractatulo de par- 
ticularibus dietis: excellentissimi | medici 
Ysaac modus imponitur: cura solerti 
padue im- 1 p[r]essus : per magistru[m] 



Mattheum Cerdonis de win- 1 dischgretz. 
die. 23. Marcij. 1487. | 

59 ff. 4 . Paduae, Matthaeus Cerdonis de 

Windischgretz, 1487. 
[Hain no. 9267.] 
First edition of the first book on diet. 

Isidorus, Bishop of Seville. [Etymolo- 
giarum Iibri viginti] [F. ia. tit:] Isidorus 
ethimologiarum | Idem de summo bono | 
[F. 99a. col. 2:] §Finit liber tertius [et] 
vltimus de summo bono sancti Isi- | do[r]i 
hyspalensis ep[iscop]i: Imp[r]essus Uene- 
tijs p[er] Bonetum] Ioca- | tellufm] man- 
date [et] expensis Nobilis viri Octauiani 
Scoti I Ciuis Modoetiensis. MCCCCXC- 
III. I Tertio Idus Decemb[r]es. Cu[m] dei 
summa Iaude. | 

100 ff. F°. Venetiis, Bonetus Locatellus for 
Octavianus Scotus, 1493. 

[Hain no. 9280.] 

Januensis, Simon [Synonyma medicinae 
s. clavis sanationis] [F. 1 blank wanting.] 
[F. 2a:] Incipit clauis sanationis elabo- 
[r]ata p[er] venera- | bilem virum magis- 
tru[m] Simonem Ianuensem | *** [F. 99a:] 
Uenetijs per Guielmum de Tridino ex | 
Monteferato. Mcccclxxxvi. die. viij. | 
Nouemb[r]is. *** 

ioo ff. F°. Venetiis, Gulielmus de Tridino de 
Monteferrato, i486. 

[Hain no. 14749.] 

Januensis, Simon [Synonyma medicinae s. 
clavis sanationis.] [F. ia:] Synonyma 
Simonis Genuensis. | Cognata non plene 
medici[n]e no[m]i[n]a reru[m] | *** [F. 
157a:] Opus imp[re]ssu[m] M[edio]I[an]i 
p[er] Antoniu[m] Zarotu[m] | parm[en]sem 
a[n]no d[omi]ni. M.cccc.Ixxiii. Die. | Mar- 
tis. iii. Augusti. | FINIS. | 

157 ff. F°. Mediolani, Antonius Zarotus, 1473. 

[Hain-Copinger no. 14747.] 

First edition of the first medical dictionary. 

Johannes Peachamus, Archbishop of 
Canterbury. [Prospectiva communis.] 
[F. 1 a. vacat.] [F. ib:] Reuerendissimo in 
Christo patri apostolicoqfue] p[r]otonota- 



62 



Annals of Medical History 



| rio nee no[n] equiti aurato [et] comiti 
palatino Amb[r]osio grff | fo artiu[m] med- 
ici[n]eq[ue] docto[r]i p[rae]sta[n]tissimo ac 
theologo p[er]itissi[m]o | Facius Cardanus. 
s. d. p. [F. 2a:] P[r]ospectiua co[mmun]is. 
d. Joha[n]nis archiepiscopi Ca[n]tuarie[n]- 
sis | fratris o[r]dinis mino[rum] *** [F. 30b. 
I. 28 :] Optima que fertur uisus pars opti- 
ma Iecto[r]. I Faustis Co[r]neni clauditur 
auspitijs. I *** 

30 ff. il. F°. [Mediolani, Petrus [Cornenus], circa 

1480.] 
[Hain no. 9425.] 
Rare work on optics. 

Jung, Ambrosius [Tractatus perutilis de 
pestilentia ex diversis auctoribus congre- 
gatus.] [F. 1 a. tit.:] Ein auszerwelt Iob- 
Iich tractat | v[o]n regiment in dem 
schwaren zeit der pestilentz ausz | gezogen 
ausz den bewarttn v[o]n weysisten alten 
gsch I rifften der artzney. Durch Am- 
brosium jung der sibe[n] | freyen kiinst 
v[o]n der artzney doctor, [die] zeit der 
wirdige[n] | herrn vom thiim aii Augspurg 
geschworner doctor. | [Icon. zyl. F. ib. 
praefatiuncula. F. 2a. c. sign. Xij:] §Die 
auszteylung dysz tractats | etc. [F. 18a.] 
Hie endet sich diser tractat des regiments 
I der pestilentz. Gedruckt und volendet 
zu I Augspurg Durch Hannsen Schonsper 
I ger am freytag nach Martini, nach Cristi 
I geburt. M.cccc. und jm.xciiij. iar. | 

18 ff. il. 4 . Augspurg, Schonsperger, 1494. 

[Hain no. 9473.] 

Rare German incunabulum. 

Jung, Ambrosius [Tractatus perutilis de 
pestilentia ex diversis auctoribus con- 
gregatus] [F. ia. tit:] Tractatulus peru- 
tilis de pe I stilentia ex diuersis auc- 
toribus aggregatus Ab exi- | mio arciu[m] 
[et] medicinafrum] docto[r]i. Amb[r]osio 
jung *** [F. 18b:] Imp[r]essum Auguste 
p[er] Johan[n]em schon | sperger Anno 
d[omi]ni Millesimo q[ua]d[r]ingete- | simo 
nonagesimo quarto. Feria quinta | post 
Elisabeth. I 



18 ff. il. 4 . Augustae, Johannes Schonsperger, 
1494. 

[Hain no. 9472.] 

Kamitus, Episcopus Arusiensis. [Regimen 
contra pestilentiam] [F. ia:] Regimen con- 
tra epidimiam siue pestem | [F. 4b :] Trac- 
tates] de regimi[n]e pestiIe[n]tico d[o]m- 
[ini] kami[n]ti ep[iscop]i Arusin[ensis] ci | 
uitatis regni dacie artis medicine exper- 
tissimi p[ro] fessoris | finem habet | 

4 ff. 4 . [Coloniae, Joannes Guldenschaff, circa 
1490.] 

[Reichling no. 957.] 

Kamitus, Episcopus Arusiensis. [Regimen 
contra pestilentiam] [F. ia. tit:] Regimen 
contra pestilentiam | siue Epidimiafm] 
Reuerendissimi domini Kaminti Episcopi 
I Arusiensis Ciuitatis regni dacie artis 
medicine expertissi | mi p[r]ofesso[r]is | 
Regimen sanitatis per circulum anni 
valde utile. | [F. 6a:] Fundamenta ruunt 
modicum tunc durat idipsum | 

6 ff. 4 . [Moguntiae, Jacobus Meydenbach, 

circa 1495.] 
[Reichling no. 582.] 

Kamitus, Episcopus Arusiensis. [Regimen 
contra pestilentiam] [F. ia. tit:] Regimen 
contra pestilentia[m] | siue Epidimia[m] 
Reuerendissimi domini Kamiuti [sic] Epis- 
copi I Arusiensis Ciuitatis regni dacie artis 
medicine expertissi | mi p[r]ofesso[r]is | 
§Regimen sanitatis per circulum anni 
valde vtile. | [F. 5a:] Incipit regimen 
sanitatis | per circulum anni valde 
vtile. I *** 

6 ff. il. 4 . [Moguntiae, Jacobus Meydenbach, 
circa 1490.] 

[Not in Hain.] 

Imperfect, j. 6 torn. 

Ketam, Joannes [Fasciculus medicinae] [F. 
1 a. tit:] Fasciculus medicine in quo | 
continentur : videlicet. | *** [F. 40b :] §Hec 
Anothomia fuit emendata ab eximio ar | 
tium *** §Imp[r]essu[m] Uenetijs per Jo- 
|anne[m] [et] G[r]ego[r]iu[m] de G[r]ego- 






Incunabula 



63 



[rjijs fratres. An | no d[omi]ni. M.cccc.xcv. 
die. xv. octob[r]is. | 

40 fF. il. F°. Venetiis, Joannes et Gregorius de 
Gregoriis, 1495. 

[Hain no. 9775.] 

Lactantius Firmianus, Lucius Coelius 
[Opera.] [F. ia:] Lactantii Firmiani de 
diuinis institutionibus | aduersus gentes. 
Rubrfcae primi Iibri incipiu[n]t. [Tab. 
expl. f. 9b.] [F. 10a:] Lactantii Firmiani 
errata primi Iibri q[ui]bus ipse | deceptus 
est per fratrem Antonium Raudensem 
I theologum collecta & exarata sunt. | 
[F. 11b in fine errator. :] His carminibus: 
frater Adam genuensis increpat fr[atr]em 
Antoniufm] | Hie male corripuit stolidis 
Antonius ausis | etc. [F. 12a incipit lib. 
divinarum institutionum s. inscr. :] (M)- 
Agno & excellenti ingenio uiri cu[m] sese 
doctrinae | etc. [F. 218b in fine:] Arguit 
hie hominum sectas lactantius omnes | 
etc. Post regina premit quippe colenda 
maris. | M. CCCC. LXXI. Adam. | 

[218] ff. F°. [Venetiis], Adam [de Ambergau], 
147 1. [Hain no. 9809.] 

Leonicenus, Nicolaus [De morbo Gallico] 
[F. 1 a. tit:] Libellus de Epidemia, quam 
I uulgo morbum Galli | cum uocant. | [F. 
28a:] Venetiis, In domo Aldi Manutii. 
Men- I se Iunio. M.iii.D. | 

29 fF. 4 . Venetiis, Aldus Manutius, 1497. 

[Hain no. 100 19.] 

Leonicenus, Nicolaus [De morbo Gallico] 
[F. 1 a. tit:] Libellus de Epidimia quam | 
uulgo morbum Galli | cum uocant siue | 
brossulas. | [F. 32a:] Liber de epidemia 
siue brossulas finis. Impressum Medio |- 
Iani p[er] magistrum Guilielmum signerre 
Rothomagensem : | regnante Illustrissimo 
principe. d. Ludouico duce Mediola | ni. 
Impensa magistri Ioa[n]nis de Legnano, 
M.cccclxxxxvij I die. iiij. mensis IuIIij. | 

32 fF. 4°. Mediolani, Guilielmus Signerre Rotho- 
magensis for Joannes de Legnano, 1497. 

[Hain no. 10020.] 

Leupoldus, Dux Austriae. [Compilatio 



de astrorum scientia.] [F. ia. tit.:] Com- 
pilatio Leupoldi ducatus | Austrie filij de 
astrorum scientia | Decern continens trac- 
tatus. I [F. 2a. sphaera mundi. F. 2b:] 
Reuerendissimo in christo patri et 
d[omi]no Udalrico de fronsperg pontifici | 
tredentino Erhardus Ratdolt Augusten- 
[sis]. imp[re]ssor Salute[m]. p. dicit. [F. 3a. 
(c. sign. a3):] § Incipit co[m]piIatio Leu- 
poldi ducatus Austrie filij de astro[rum] 
scie[n]tia. | [F. 109a:] Compilatio Leupoldi 
ducatus Au- 1 strie filij de astrorum scientia : 
expliciter | feliciter. Erhardi ratdolt Au- 
gusten[sis]. | viri solertis : eximia industria 
[et] mira | imprimendi arte: qua nupfer] 
venecij | nunc auguste vindelicorum ex- 
cellit I nominatissimus. Quinto ydus Ia | 
nuarij. M.cccc.Ixxxxix currente. | Laus 
deo. I no ff. 12 . Augusburg, Ratdolt, 
1489. 

[Hain-Copinger no. 10042.] 
First Edition. 

Lucian of Samosata. [Dialogus.] [F. 20a. 1. 
26:] LVCIANI PHILOSOPHI GRAECI 
DIALOGVS DE VIR | tute, conquer- 
e[n]te cum Mercurio. a Carolo aretino 
graeco in Iatinu[m] traductus. | 

[In- Censorinus. De die natali. *** 1497. F. 20.] 

Lucretius Carus, Titus De rerum natura. 
[F. 1. blank. F. 2a. c. sign, all:] T. Lu- 
creti Cari. poetae philosophici antiquis- 
simi I de rerum natura liber primus incipit 
foeliciter. | [F. 95a. 1. 10:] Paulus hunc 
impressit fridenperger in uerona. | *** Ab 
incarnatione christi: MccccLxxxvi | Die 
uigesimo octauo septembris calen. octo- 
bris. I *** Finis. | 

96 fF. 4 . Veronae, Paulus Fridenperger, i486. 

[Hain no. 10282.] 

Second issue 0/ this work, but the first dated 
edition. Only work from this press. 

Ludovicus Pruthenus s. de Prussia. [Tril- 
ogium animae] [F. ia. tit:] Trilogium 
anime | non solum religiosis veru[m]- 
etia[m] se | cularibus p[r]edicato[r]ibus 
co[n]fes J so[r]ibus contemplantibus et stu- 



64 



Annals of Medical History 



|dentibus Iumefn] intellectus et ar | dorem 
afFectus amministrans | [Ad fmem:] §Post 
hoc in imp[er]iali ciuitate Nuremberg ad 
p[r]eces | fratru[m] mino[rum] ibide[m] 
co[m]mo[r]antiu[m] : p[er] Anthoniu[m] ko- 
ber- I ger ad Iaude[m] dei imp[r]essum [et] 
ad hu[n]c vsq[ue] fme[m] feliciter | p[er]- 
ductu[m] Anno d[omi]ni. M.cccc.xcviij.vj. 
die Marcij. | 

354 fF. il. 1 woodcut. 4°. Nurembergae, Anthon- 
ius Koberger, 1498. 

[Hain no. 103 15.] 

[Lumen animae seu liber moralitatum.] 
[F. 1 a:] §Liber moralitatum elegantissi- 
mus magnarum rerum naturaliu[m] | Lu- 
men anime dictus. cum septem appari- 
toribus. necno[n] sancto[rum] docto[rum] 
o[r]thodoxe fidei [projfessorum. Poetarum 
etiam ac orato[rum] auctori | tatib[us]. 
p[er] mo[dum] pharatre [secundu]m o[r]- 
dine[m] alphabeti collectis. Felicitfer] in- 
cipit I [F. 2a. Tabula. F. 32b.] Tabula 
moraIitatu[m] Secunda super Lume[n] 
anime finit feliciter. | [F. 33a:] Prologus. | 
[F. 34b:] Titvlvs Primus | [F. 268a. In 
fine:] §Liber lumen anime dictus feliciter 
explicit.*** Annoq[ue] a natiuitate d[omi]- 
ni. Milesimoquadringentesimo sep | tua- 
gesimo nono quarta feria post vdalrici, 
su[m]ma cu[m] dilige[n]tia [com]pIe[tus] | 

268 ff. F°. [Reutlingae, Michael Greyff], 1479. 

[Hain-Copinger no. 1033 1.] 

Macer Floridus, Aemilius [De viribus 
herbarum] [F. ia:] Incipit Iibellus Macri 
de viribus | herbarum. Et p[r]imo de 
arthemisia. | [Ad finem:] Herbarum var- 
ias qui vis cognoscere vires | Macer adest 
disce: quo duce doctus eris. | 
43 fF. il. 4 . n. p., n. pub., [circa 1491.] 
[Hain no. 104 19.] 

Magni, Jacobus. [Zophilogium s. sopho- 
Iogium.] [F. ia. tit. :] Sophologium sapie- 
[n]tie magistri Jacobi magni. [Woodcut.] 
[F. 2a. woodcut portrait-initial:] Doctis- 
simi *** Jacobi magni *** sophologium 
incipit. I *** [F. i4ib.coI. 2. 1. 19:] Jacobi 
magni sopho!ogiu[m] sapien- | tie finit fe- 



liciter. I [F. 142-143. tabula. F. 144b. full- 
page woodcut printer's device.] JEHAN 
RICHART *** 

144 fF. 12°. [Parisiis, Felix Balligault for 

Jean Richart, 1498.] 
[Copinger no. 3748.] 

Magninus Mediolanensis. [Regimen sani- 
tatis] [F. 1 a. tit:] [R]Egime[n] sanitatis 
Magnini medio | Ianensis medici famosis- 
simi attre | bacensi episcopo directum 
*** [F. 128a:] Explicit. [ 

130 fF. 4 . [Lyons, n. pub., circa 1495.] 

[Hain no. 10482.] 

Maldura, Petrus Ludovicus [In vitam 

Sancti Rochi *** ] [F. ia. tit:] Petrus 

Iudouicus Maldu | ra In Uitam sancti 

Rochi I Contra Pestem Epidimie Apud 

d[omi]n[u]m dignissi | mi intercesso[r]is 

Unacu[m] eiusdem Officio. | [F. 12a:] 

Theoderici gresemu[n]di Iunio[r]is mo- 

guntini Car- | men EIegiacu[m] ad huius 

Iibri Iecto[r]em in Iaudem | sancti Rochi. 
1 *** 

12 fF. il. 4 . [Moguntiae, Petrus de Friedberg, 

1495.] 
[Hain no. 10546.] 

de Manfredi, Hieronimus [Liber de nom- 
ine, cuius sunt Iibri duo ***] [F. ia. blank.] 
[F. ib:] MEA interest magnifice ac gen- 
erose Miles Iohannes d[e] bentiuoliis | 
*** [F. 2a. col. 1 :] LIBER DE HOMINE: 
CVIVS Su[n]t LIBRI DVO. PRIMVS 
LIBER DE I CONSERVATIOne SANI- 
TATIs I CAPITVLVM PRIMVM DE 
Ca I VSIS & NATVRIS OMNIV[M] Eo |- 
RVM QuAE SVMVNTVR IN | CIBO. 
QuESITA. LXX. QuAESI | TVM 
PRIMVM. I [F. 109-110 wanting.] 

1 10 ff. F°. [Bononiae, Ugo Rugerius et Doninus 
Bertochus, 1474.] 

[Hain no. 10689.] 

Imperfect, ff. 109-110 missing. 

Magni, Jacobus [Zozhilogium s. sopholo- 
gium.] [F. 1 a. tit.:] Sophologium sapiefn]- 
tie I magistri Jacobi magni. | [Woodcut.] 
[F. 2a. woodcut portrait-initial:] DOctis- 
simi *** Jacobi magni *** sophologium in- 



Incunabula 



65 



cipit. *** [F. 141b. col. 2. 1. 19:] §Jacobi 
magni sophoIogiu[m] sapien- 1 tie finit 
feliciter. | [F. 142-143. tabula. F. 144b. 
full-page woodcut printer's device.] JE- 
HAN RICHART. | *** 

144 ff. 12°. [Parisiis, Felix Balligault for Jean 

Richart, 1498.] 
[Copinger no. 3748.] 

de Manliis de Bosco, Joannes Jacobus 
[Luminare maius.] [F. ia. tit:] Luminare 
maius. | Cinthius vt totum radijs illu- 
minat o[r]bem. | Illustrat Iateb[r]as sic 
medicina tuas. | [Ad finem:] Opus dili- 
genter co[rr]ectum [et] a multis docto[r]- 
ib[us] I examinatum. Imp[r]essum in in- 
clita ciuitate Papie stu | dio[r]um omnium 
altrice per magistrum Antonium [de] | 
Carchano MedioIane[n]sem imp[r]esso- 
[r]e[m] dignissimum. | Anno saluatoris 
nostri. 1494. *** 

90 ff. F°. Papaie, Antonius de Carchano, 1494. 

[Hain no. 10711.] 

Martius, Galeotus [Liber de homine] [F. 
1 blank.] [F. 2a:] GALEOTTI MARTI I 
NARNIENSIS I AD. R. D. ARCHIE- 
PISCOPVM STRIGO I NIENSEM IN 
LIBRVM DE HOMINE EPISTOLA. 
*** [F. 76a:] Galeotti Martii Narniensis 
Secundus & ultim[us] | de homine Liber 
explicat. | 

76 ff. F°. [Budapest, circa 1470.] 

[Hain no. 7433-1 

Martius, Galeotus [Refutatio objectorum 
in Iibrum de homine a Georgio Merula] 
[F. 1 blank wanting.] [F. 2a:] Galeotti 
Martii Narnie[n]sis Epistola Ad IIIu | stri. 
Pri[n]cipe[m] Federicu[m] Duce[m] Vrbini 
Incohat | [F. 104a:] Impressu[m] est opus 
Venetiis mirabili arte | ac diligentia Per 
Iacobum Rubeum Na | tione Gallicum 
huius artis p[er]itissimum. An | no incar- 
nationis dominice millesimo cccc | Ixxvi. 
Andrea Vendremino inclyto Duce | Vene- 
tiarum. | Laus omnipotenti deo. | 

104 ff. 4 . Venetiis, Jacobus Rubeus, 1476. 

[Hain no. 7437.] 

Imperfect, ff. $3-68 missing. 



Matheolus Perusinus. [De memoria 
augenda s. ars memorativa.] [F. ia:] 
Tractatus clarissimi philosophi et me | 
dici Matheoli perusini de memo[r]ia au- 
ge[n] I da per regulas et medicinas. | [F. 
5b:] Explicit tractatus de memo[r]ia editus 
in I Italia a d[omi]no Matheolo medicine 
docto[r]e | famosissimo. mo[r]tuo Anno 
d[omi]ni milesimo | quad[r]ingentesimo 
septuagesimo. | [F. 6 blank.] 

6 ff. 4 . [Argentinae, Heinrich Knoblochtzer, 
circa 1475.] 

[Copinger no. 3912.] 

Matheolus Perusinus. [De memoria au- 
genda s. ars memorativa.] [F. ia:] 
§TRACTATVS CLARISSIMI PHILO | 
sophi & Medici Matheoli Perusini: de 
Memoria. | [F. 4b:] §Hec igitur sunt uiri 
digni medicinalia que inter | alia elec- 
tissima pro seruanda memoria & ita 
fine[m] facio. | 

4 ff. 4 . [Romae, Eucharius Silber, circa 1476.] 

[Reichling no. 253.] 

Matheolus Perusinus. [De memoria au- 
genda s. ars. memorativa.] [F. ia:] §Trac- 
tatus Clarissimi philosophi et | medici 
Matheoli Perusini de Memo[r]ia. | [F. 4a:] 
§Hec igitur sunt viri digni medicinalia que 
I inter 'alia electissima p[r]o seruanda 
memo[r]ia: [et] | ita finem | facio. | 

4 ff. 4 . [Romae, Stephanus Plannck, circa 

1490.] 
[Reichling no. 1570.] 

Matthaeus de Lucha. [De diebus criticis.] 
[F. 1 a. blank.] [F. ib:] Ad Lectorem. | 
*** [F. 2a:] §Artiu[m] & medicine doctoris 
magistri Mat | thei de Lucha de diebus 
creticis Dialogus. | [F. 8b:] §Impressum 
Rome. Mcccclxxxxiii. Beatis | simo Alex- 
andra sexto imperante quern de | us con- 
seruet. | 

8 ff. 4°. Romae, [Andreas Fritag], 1493. 

[Hain no. 10257.] 

Mensa philosophica. [F. i a. tit:] Mensa 
philosophica. | [F. 2a:] §Incipit tabula 
in Ii J bru[m] qui dicit[ur]. Men | sa philo- 



66 



Annals of Medical History 



sophica. Et | p[ri]mo ponu[n]tur tituli | 
p[r]imi Iib[r]i | [F. 96b:] Presens liber 
que[m] mensa[m] phiIosophica[m] vo | 
cant: vnicuiq[ue] p[er]utilis: co[m]pen- 
diose p[er]tractans | in p[ri]mis q[ui]d in 
co[n]uiuijs p[ro] cibis et potibus su= | 
mendu[m] est. deinde que sermones illis 
[secundujm exi= | gentiafm] p[er]son- 
aru[m]habe[n]di su[n]t: etque q[ue]stiones 
I discutie[n]de : q[ue] insup[er] facetie siue 
ioci intersere[n]di | Feliciter explicit. | 

96 fF. 8°. [Coloniae, Joh. Guldenschaaf, circa 
1485.] 

[Hain no. 11075.] 

Mesue Damascenus, Joannes [Eadem op- 
era cum additionibus et expositionibus 
aliorum] [F. ia. tit:] Mesue cum addi- 
tionibus Francisci de pedemontium. Et 
ad I ditionibus Petri de Apono. Et cum 
commento Dini super | Cano. generales. 
Et cum co[m]me[n]to Christophori de 
honestis | sup[er] antidotariu[m] Mesue 
Platearius super antidotariu[m] Nicolai | 
Et Saladinus de componendis medicinis. | 
[F. 357b:] Hie finitur Mesue cum Mundi- 
no super canoni- | bus generalibus Chris- 
tofaro Geo[r]dio *** Et imp[r]essa Uene- 
tijs per Pelegrinum de | pasqualibus de 
Bononia sub a[n]no d[omi]ni. 1491. *** 
LAUS DEO. I 

358 fF. F°. Venetiis, Pelegrinus de Pasqualibus 
de Bononia, 1491. 
[Hain no. imo.] 

Mesue Damascenus, Joannes [Eadem op- 
era cum additionibus et expositionibus 
aliorum] [F. 1 blank.] [F. 2a:] [I]N nomine 
I dei mise[r]ico[r] | dis cui[us] nutu [ser]mo 
recipit | gra[tiam] [et] doctrina p[er]fec- 
tione[m] | *** [F. 391a:] Hoc Ioci consum- 
[m]atur vniuersa opera Diui | Ioannis Me- 
sue cum complemento *** An | no salua- 
to[r]is cristi Iesu. M.iiij.Ixxviiij. p[er] | die 
kale[n]das Feb[r]uarij. Imp[r]essa venetijs 
op[er]e et impensis Rainaldi Nouimagij.*** 

392 fF. F°. Venetiis, Rainaldus de Novimagio, 
1479. 

[Hain no. 11 108.] 



Metlinger, Bartholomaeus [Regiment 
der jungen Kinder] [F. ia:] [W]Ann nach 
ansehung gotlicher | vnd menschlicher 
o[r]denung *** [F. 27b:] da | mit sich das 
vierd capitel endet v[o]n dar dur | ch 
dises buchlin Dar von got dem almechti 
I gen Er wurd v[o]n lob gesagt sey vnd 
seiner | werde[n] muter der iungfrauwefn] 
marie Gesche | hen als ma[n] zalt nach 
xpi geburt tauset vier= | hundert vnd 
in de[n] Ixxiij. jar an dem achten | den 
tag sant End[r]is des zwolff boten. | 

27 fF. F°. [Augustae, Gintherus Zainer], 1473. 

[Hain no. 11 127.] 

/. 21 replaced by facsimile. 

Molitor, Ulricus [De Iamiis et phitonicis 
mulieribus.] [F. ia.] §De Ianijs [sic] [et] 
phitonicis mu | Iieribus ad illustrissimum 
p[r]incipem dominu[m] Sigismundum | ar- 
chiducem austrie tractatus pulcherrimus.| 
[Woodcut.] [F. 22a. I. 26.] Ex Constantia 
anno domini. M.cccc.Ixxxix: die | decima 
mensis Januarij. | §Tue celsitudinis hum- 
ilis consiliarius [et] seruulus | Ulricus moli- 
to[r]is de Consta[n]tia decreto[rum] doc- 
to[r]. I 

22 fF. il. 7 woodcuts. 12 . [Cologne, Cornelius 
de Zierikzee, circa 1490.] 

[Copinger no. 433§?] 

Most famous XVth century work on witchcraft. 

Montagnana, Bartholomaeus [Consilia 
medica] [F. ia. tit:] Consilia Magistri 
Bartholomei Montagnane. | Tractatus 
tres de balneis patauinis. | De composi- 
tione et Dosi medicinarum. | Anthido- 
tarium eiusdem. | Consilia D[omi]ni An- 
tonii Cermisoni. | Tractatus de theriaca: 
a Fra[n]cisco caballo editfus] | [F. 401b. 
n. 405b:] §Hoc uolumen Imp[r]essum est 
Uenetijs per | Simonem de Luere Impe[n]- 
sis D[omi]ni Andree | To[r]resani de 
Asula. xx. Aug. M.ccefcic. | *** 

420 fF. F°. Venetiis, Simon de Luere for Andreas 

Toressani de Asula, 1499. 
[Copinger no. 4342.] 
Imperfect, ff. 402-420 missing. 



Incunabula 



67 



Montagnana, Bartholomaeus [Consilia 
medica] [F. 1 missing.] [F. 2a:] §Gerardo 
bolderio Uerone[n]si tanq[uam] patri ob- 
seruandissi- | mo Jacobus de vitalibus 
B[r]ixiensis. S. P. D. | [F. 395b: (c. n. 387)] 
§Gratias altissimo deo qui antidotis 
d[omi]ni magistri Bar- | tholomei de 
mo[n]tagnana. Et [con]seque[n]ter toti[us] 
huius op[er]is fi | nem i[m]ponere dedit. 
Ma[n]dato ac sumptibfus] nobilis viri 
d[omi]ni Octauiani Scoti ciuis Modoe- 
tie[n]sis. quarto nonas Au- | gusti. 1497. 
per Bonetu[m] LocateIIu[m] Bergomen- 
sem. [ 

396 ff. F°. [Venetiis], Bonetus Locatellus for 

Octavianus Scotus, 1497. 
[Hain no. 11552.] 

Montagnana, Bartholomaeus [De uri- 
narum judiciis] [F. ia:] Tractatus de 
v[r]inaru[m] iudicijs p[er]utilis excel | Ie[n]- 
tissimi viri Bartholomei de montegnana | 
[F. 25b:] Imp[r]essus padue per Magis- 
trum Matheum cerdonis de | vindisch- 
grecz. Anno d[omi]ni. 14. 87. die vero. i7. 
me[n]sis feb[r]uarij. | 

26 ff. 4 . Paduae, Matthaeus Cerdonis de Win- 
dischgretz, 1487. 

[Hain no. 11553.] 

de Montis, Petrus [De diagnoscendis 
hominibus Iibri sexti] [F. ia. tit:] 
PETRVS MONTIS DE DIGNOS- 
C E N D I S HOMINIBVS | INTER- 
PRETE G. AYORA CORDVBENSI. | 
[F. 228b:] CONSVMATVM EST. | An- 
tonius Zarotus Parmensis Mediolani hoc 
Opus impressit Mille | simoquadringen- 
tesimo nonagesimosecundo : secto decimo 
I Chalendas Ianuarii. *** 

228 ff. F°. Mediolani, Antonius Zarotus, 1492. 

[Hain no. 11608.] 

Moses Maimonides [Abu Amran Musa 
Ben Meimun] [Aphorismi medici.] [F. ia:] 
§Incipiunt aphorismi excellentissimi Raby 
Moyses se | cundum doctrinam Galieni 
medicorum principis. | [F. 133b:] Bononie 
i[m]pressum impensa Benedicti Hectoris 



Iibrarii: Ope | ra uero Platonis diligentis- 
simi impressoris Bononiensium. | Anno 
gratie. M.cccc.Ixxxviiii. quarto calendas 
Iunii. I *** [F. 135a:] Amphorismi [sic] 
Iohannis damasceni. [ ***[ F. 154a:] §Finis. | 
§Laus deo. | 

154 ff. 4°. Bononiae, Plato de Benedictis for 
Benedictus Hectoris, 1489. 

[Hain no. 10524.] 

Motis, Johannes [Invectiva coetus feminei 
contra mares] [F. ia. tit:] §TractatuIi 
duo metrici b[r]eues, quofrum] p[r]imus | 
continet recommendationem seu defen- 
sio- 1 nem mulierum contra viros seu 
mares. | §Secundus remedium viro[r]um 
contra con- | cubinas atq[ue] coniuges 
[et]c. ] [F. 8b:] §Quinq[ue] sunr [sic] que 
p[er]turba[n]t [ rempublica[m] siue bonu[m] 
co[mit]e. | *** 

8 ff. 4 . [Memmingen, Albertus Kunne, circa 

1500.] 
[Hain no. 11623.] 

Nicephorus. [Logica cum aliis aliorum 
operibus Georgio Valla interprete] [F. 
1 a. tit:] Geo[r]gio Ualla Placentino Inter- 
prete. I [F. 156b:] §Impressum Venetiis 
per Simone[m] Papiensem di | ctum Beuil- 
aquam. 1498. Die ultimo Septembris | 
Cum gratia [et] p[r]iuiIegio. | *** 

156 ff. F°. Venetiis, Simon Papiensis Bevilaqua, 

1498. 
[Hain no. 11748.] 

Nicolaus Praepositus Salernitanus. 
[Antidotarium***] [F. ia:] Iohannis Me- 
sue Grabadin In | cipit Quod est aggre- 
gacio [et] an = | tidotarium electuario- 
[r]um et co[n] | fectionum [F. 45a:] [A]Nti- 
dotarius Nicolai medi | cinalis cum omni- 
bus suis I receptis Incipit feliciter. | [F. 
67b:] Antidotarius medicinalis | Nicolai 
Explicit. I [F. 68a:] Liber seruito[r]is de 
p[r]eparac[i]oni | bus medicinafrum] ta[m] 
Iapidu[m] mine= | raliu[m] q[uam] radi- 
cu[m] pla[n]ta[rum] ac etia[m] me | dici- 
[n]a[rum] ex a[n]i[m]alib[us] su[m]pta- 
[rum] *** 



68 



Annals oj Medical History 



95 ff. F°. [Argentorati, Johannes Priiss, circa 

1480.] 
[Hain no. 11762.] 
Imperfect, ff. 45 & 46 mutilated, ff. 93-g^ 

missing. 

Nider, Joh. [Tractatus de morali lepra.] 
[F. 1 a:] Jncipit (sic) tractatus venera- 
bil[is] magistri. Joha[n] | nis Nider ordinis 
p[re]dicato[rum]. De morali lepra | [O]- 
Lim deum Iegim[um] [etc.] [F. 102b. 1. 19:] 
Explicit tractatus de lepra morali. Fra- 
tris. Jo I ha[n]nis. Nyder sacre theologie 
professoris ordinis predicatorum. | 

104 ff. 8°. (22cm.) [Colon., Zell, circa 1470.] 

[Hain-Copinger no. 11814.] 

[Proctor no. 844.] 

First edition. Extremely rare. One oj the only 
two copies oj this edition in America. 

[F. 103 & j. 104 blank.] 

de Nursia, Benedictus [Libellus de con- 
versatione sanitatis secundum ordinem 
alphabeti distinctus] [F. ia blank.] [F. 
ib:] Pulcherrimum & utilissimu[m] opus 
ad I sanitatis co[n]seruationem. *** Incip- 
it foeliciter. | *** [F. 139b:] Tractatus qui- 
dam de regimine sani | tatis opera & 
industria Dominici de | Lapis, impendio 
tamen Sigismundi | a Iibris ciuis atqfue] 
Iiberarii Bononien | sis feliciter finiunt. 
I Anno. D.M.CCCC.Ixxvii. | 

140 ff. 4 . Bononiae, Dominicus de Lapis, 1477. 

[Hain no. 1 1920.] 

de Orbellis, Nicolaus [Logica.] [F. ia. 
tit:] Logica Magistri Nicolai de Orbellis 
una cum | textu Petri hyspani. | [F. 134a:] 
Explicit Logica magistri Ni | colai de 
o[r]beIIus vna cum te- | xtu Petri hispanus 
feliciter. | Imp[r]essa Uenetiis per AI- |- 
bertinufm] Uercellensem : die. x. | Marcii. 
M.ccccc. I Registrum. | abcdefghiklmnop- 
| qr. Omnes sunt quarter | ni p[ra]eter r 
que est ternus. | 

134 ff. diag. 8°. Venetiis, Rubeus, 1500. 

[Hain-Copinger no. 12052.] 

Commentary on the writings of Petrus Hispanus 
who became the medical Pope, John XXI. 



Ortolff [Heydenberger] von Bayr- 
landt [Artzneybuch] [F. ia:] Hie hebt 
sich an das register des [ nachuolgenden 
artzeneipuchs | *** [F. 4b:] Nach Christi 
vnse[r]s Iieben herre[n] gepurt als man 
zalt Tau= | sent vierhundert vnd siben- 
vndsibentzig Iar *** Nurenberg 1st di- 
[eses] Artzneipuch mit sunderm fleis durch 
I Anthonij koburger Burger daselbs ged- 
[r]iickt *** [F. 84a. 1.7:] ein ende. | 

84 ff. 4 . Numbergae, Anthonius Koburger, 

1477. 

[Hain no. 121 12.] 

Paulus Venetus, Nicolettus [Expositio 
Iibrorum naturalium Aristotelis.] [F. 1 
blank wanting.] [F. 2a:] [PJLurimo | ru[m] 
astri- I ctus p[re]cibus: quo[r]u[m] p[ri]- 
de[m] mee i[n]troductio [ nis *** [F. 215b:] 
Explicit sexta [et] vltima pars su[m]me 
natu- I raliufm] *** [con]fecto Uenetijs im- 
p[r]essione[m] habuit i[m]pen | sis Ioha[n]- 
nis de Colonia socijq[ue] eius Io | hannis 
ma[n]then de Gherretzem. Anno a | natali 
ch[r]istiano M.cccc.Ixxvi. | 

223 ff. F°. Venetiis, Johannes de Colonia et 

Johannes Manthen de Gerretzem, 1476. 
[Hain no. 12515.] 

Petrus de Abano. [Conciliator differen- 
tiarum philosophorum et praecipue medi- 
corum] [F. 1 blank] [F. 2a:] ConciIiato[r] 
differentiaru[m] phiIosopho[r]u[m] [et] 
p[r]eci I pue medico[rum] clarissimi viri 
Petri de Abano Pata | uini feliciter in- 
cipit. [F. 280b:] §Exegimus deo fauto[r]e 
op[us] Co[n]ciIiato[r]is magistri | Pet[r]i ab 
Aba[n]o medico[rum] physico[rum] q[ue] 
sua tempesta | te p[ri]ncipis: impe[n]sa 
v[er]o caractereqfue] incundissimo ma |- 
gistri Ioha[n]nis herbo[r]t de Selge[n]stat 
alemani cuius | ars [et] ingeniu[m] ceteros 
facile supe[re]minet o[mn]es: Impres | sum 
Uenetijs a[n]no v[m]. £483. nonis feb[r]- 
uis. I *** 

284 ff. F°. Venetiis, Johannes Herbort de 
Seilgenstat, 1483. 

[Hain no. 6.] 



Incunabula 



69 



Petrus de Abano. [Conciliator differen- 
tiarum philosophorum et praecipue medi- 
corum. Eiusdem tractatus de venenis.] 
[F. 1 blank.] [F. 2a:] ConciIiato[r] differen- 
tiaru[m] phiIosopho[r]um [et] p[r]eci | pue 
medico[rum] clarissimi viri Petri de Abano 
Pa- I tauini feliciter incipit. *** [F. 280b:] 
Exegimus deo fauto[r]e opus Co[n]ciIiato- 
[r]is magi- | stri Petri de abano medico [- 
rum] physico[rum] q[ue] sua tern- | pestate 
p[r]incipis: Imp[r]essum papie per Gab- 
[r]iele[m] j de grassis anno d[omi]ni. i490. 
die sexta. nouemb[r]is. | *** [F. 293b:] 
LAUS DEO. 

293 ff. F°. Papiae, Gabriel de Grassis, 1490. 

[Hain no. 3.] 
Petrus de Abano. [Expositio problematum 
Aristotelis.] [F. 1-3:] Tabula. *** [F. 4. 
cum sign. a2.] Expositio p[r]eclarissimi 
atq[ue] eximii artium ac medi | cine doc- 
to[r]is Petri de Ebano Patauini in Iib- 
[rum] I p[r]obIematum Aristotelis feliciter 
incipit. I [F. 312 a. cum sign. Q6, in fine:] 
Explicit *** ea nullo p[r]i | us interp[r]e- 
tante incepta quidem Parisius [sic]: et 
Iaudabiliter Padue terminata. arte hac 
impen | sa Joannis herbo[r]t Alemani *** 
verum ut Iaute sint etiam eIabo[r]ata. | 
Anno. M.cccc.Ixxxii. die. xxva. Feb[r]uarii. 
I [F. 312b. Register.] 

312 ff. F°. [Venetiis, Herbort, 1482.] 

[Hain-Copinger no. 17.] 

Petrus de Abano. [Tractatus de venenis.] 
[F. 1 a:] Incipit p[ro]Iogus in Iibellum de 
vene [ nis: ExceIIentiss[i]mi medici m[a]g- 
[ist]ri Pe | tri de Abbano. Anno d[omi]ni. 
i. 4. 8. 7. I [F. 34a:] Et sic imponit[ur] 
finis tractatui de vennenis [sic] peritissimi 
medici magistri Petri de abba | no *** 
Imp[re]ssus p[er]. p. matheu[m] cerdois 
[de] vni | dischgrecz. Anno d[omi]ni. i. 
4. 8. 7. die i8 dece[m]bris. | 

36 ff. 4 . [Paduae], Matthaeus Cerdonis de 
Windischgretz, 1487. 

[Hain no. 12.] 

Petrus de Abano. [Tractatus de venenis.] 



[F. 1 a. blank.] [F. ib:] §Tractatus de 
Uenenis : a magistro Petro de Albano [sic] 
editfus]. I [F. 1 8b:] §Finit Tractat[us] vti- 
Iissimus de venenis per magi | stru[m] 
Petru[m] de Abbano [com]positus. Im- 
p[r]essus Rome | Anno d[omi]ni. M.cccc- 
Ixxxx. die v[er]o. xvii. Marcij. | 

18 ff. 4 . Romae, [Stephanus Plannck], 1490. 

[Hain no. 13.] 

Petrus Hispanus. [Pope John XXI] [Prac- 
tica medicinae, quae thesaurus pauperum 
nuncupatur.] [F. 1 wanting.] [F. 2a:] QVI 
IN COMINCIA IL LIBRO CHIAMATO 
I TESORO DE POVERI COMPILATO 
I ET FACTO PER MAESTRO | PIERO 
SPANO. *** [F. 70b:] Stampata in Vene- 
cia per Gioan ragazzo & Gioan | maria 
Compagni. del. M.cccclxxxxiiii. | adixxvii. 
Marzo. Laus Deo. ] *** 

70 ff. 4 . Venecia, Giovanni Ragazzo e Gio- 
vanni Maria [da Occimiano], 1494. 

[Hain no. 8715.] 

Imperfect, f. ai title-page, missing. First dated 
Italian edition. 

Peyligk, Johannes [Compendium philo- 
sophiae naturalis] [F. ia. tit:] Philosophic 
Naturalis | Compendium] Lib[r]is phi | 
sico[r]um *** [F. 97b:] *** Imp[re]ssu[m] 
est opus istud in insigni oppido Liptzensi 
ope- 1 ra [et] solertia Melchiar Lotter 
Anno salutifere incarnat[i]o[n]is Mil | Iesi- 
mo quad[r]ingentesimononogesimonono 
p[r]idie idus septe[m]b[r]is | 

97 ff. F°. Lipsiae, Melchior Lotter, 1499. 

[Hain no. 12861.] 

Pico della Mirandola, Giovanni count 
[Opera.] [v. 1. F. ia. tit:] Conmentationes 
[sic] Ioannis Pici Mirandulae in hoc uolu | 
mine co[n]tentae : quibus anteponit[ur] uita 
per Ioanne[m] fran | ciscum illustris prin- 
cipis Galeotti Pici filium co[n]scripta. | 
*** [F. 151a:] Diligenter impraessit Bene- 
| dictus Hectoris Bononien. adhibita pro 
uiribus solertia & dilige[n]tia ne ab arche- 
typo ab I erraret: Bononiae Anno Salutis. 
Mcccclxxxxvi. die uero. xx. Martii. I 



70 



Annals of Medical History 



[Registrum.] [v. 2. F. ia. tit.:] Disputa- 
tiones Ioannis Pici Miran | dulae litter- 
arum principis | aduersus astroIogia[m] | 
diuinatricem qui | bus penitus sub | neruata 
cor I ruit | [F. 3a-6a:j Tabula. [F. 7a:] 
Prooemium. | IOANNIS PICI MI- 
RANDVLAE CONCORDIAE COMI- 
TIS IN DISPVTA I TIONES AD- 
VERSVS ASTROLOGOS. | [F. 126a:] 
Finis I Disputationes has Ioannis pici Mi- 
randulae concordiae Comitis | Iitterarum 
princi [ pis aduersus astrologos : diligen- 
ter. I 

2 v. in 1. [152 & 126] ff. il. F°. Bononia, Bene- 
dictus Hectoris, 1496. 

[Hain-Copinger no. 12992.] 

Imperfect. J. 24 of v. 2 missing. First edition, 
including his medical and astrological treat- 
ises. 

Pintor, Petrus [Aggregator sententiarum 
doctorum de praeservatione curationeque 
pestilentiae.] [F. 1 blank.] [F. 2a:] §Ad 
beatissimum [et] clementissimum Domi- 
num nostru[m] dominum AIex[an]drum 
se I xtum Pontifice[m] Maximu[m] Petrus 
Pinto[r] arcium medicine Magister p[r]e | 
fateq[ue] sanctitatis medicus hu[n]c Iibel- 
Ium dirigit qui agregato[r] sentenciarum 
doc I torum omnium de p[r]eseruatione 
curationeq[ue] pestilentie intitulatur. | [F. 
92a:] Explicit Iibellus agregato[r [sic] sen- 
tentiarum doc- I to[r]um omnium de p[r]e- 
seruatione [et] curatione | pestilentie inti- 
tulatus *** p[r]efateq[ue] sanctitatis medi- 
cu[m] Rome imp[r]essus | per venerabilem 
viru[m] Magistru[m] Eucharium | Silber 
Anno salutis. M.ccccic. Die. xx. men | sis 
Feb[r]uarij. | 

92 ff. F°. Romae, Eucharius Silber, 1499. 
[Hain no. 13009.] 

Platina, Bartholomaeus [De honesta vol- 
uptate.] [F. 1 a:] Platyne de Honesta 
Voluptate: [et] Valitudi[n]e. ad | Amplis- 
simu[m] ac Doctissimum. D. B. Rouerel- 
Iam. S. CIeme[n]tis | Presbiteru[m] Cardi- 
nalem. | [F. 89b:] Finis. | Viri doctissimi 



Platyne opusculum de obso- 1 niis: ac 
de honesta voluptate [et] valitudi | ne: 
impressu[m] in Ciuitate Austrie: | impen- 
sis [et] expensis Gerardi | de Flandria. 
Venetiaru[m] | Duce Inclito Io= | hanne 
Moce[n]ico. | Nono Kalendas Nouembris 
I .M°.cccc°.Ixxx°. I Laus Omnipotenti 
Deo. [F. 9oa~93a tab. F. 93b registr.] 

92 ff. 12°. Civitate Austrie, Gerardi, 1480. 

[Hain no. 13052.] 

First book printed in Cividale. 

Platina, Bartholomaeus [De honesta vol- 
uptate.] [F. 2a:] Platynae De Honesta 
Voluptate: et Valitudine. ad Am | plis- 
simum ac Doctissimum. D. B. Rouellam. 
S. Clementis | Presbiterum Cardinalem. | 
[F. 90b:] Habes splendidissime lector 
uiri doctissimi Platinae opu- | sculum de 
obsoniis: de honesta uoluptate ac ualitu- 
dine di- | Iigenterq[ue] Bononiae Impres- 
sum per Ioanne[m] antonium pla 1 toni- 
dem Benedictorum bibliopolam necno[n] 
ciuem Bono | niensem sub Anno domini. 
Mccccxcix. die uero. xi. mensis | Maii 
Ioanne Bentiuolo foeliciter illustrante. | 

95 ff. 4 . Bononiae, Johannes Antonius Bene- 
dictorum, 1499. 

[Hain no. 13056.] 

Imperfect, ff. 1 & 8 missing. 

Plinius, Cajus Secundus [Historia natur- 
alis.] [F. 1 a:] HISTORIA NATVRALE 
DI. C. PLINIO SECONDO | TRADOC- 
TA DI LINGVA LATINA IN FIOREN- 
TINA I PER CHRISTOPHORO LAND- 
INO FIORENTINO | AL SERENISSI- 
MO FERDINANDO RE DI NAPOLL 
I PROHEMIO. I [F. 5a:] LIBRO PRIMO 
DELLA NATVRALE HISTORIA DI. 
C. I PLINIO SECONDO TRADOCTA 
IN LINGVA FIOREN | TINA PER 
CHRISTOPHORO LANDINO FIO- 
RENTI I NO AL SERENISSIMO FER- 
DINANDO RE DI NAPOLL | PREFA- 
TIONE. I [F. 413b:] OPVS NICOLAI 
IANSONIS GALLICI | IMPRESSVM | 
ANNO SALUTIS. M.CCCCLXXVI. | 
VENETIIS. I 



Incunabula 



7i 



413 ff. F°. Venetiis, Nicolaus Janson Gallicus, 

1476. 
[Hain no. 13105.] 
Believed to be the first Italian edition of any 

classic. 

Plutarch. [De invidia et odio.] [F. 37a (c. 
sign, h):] PLVTARCHI LIBELLVS DE 
DIFFERTIA INTER | ODIVM ET 
INVIDIAM INCIPIT FOELICITER. | 

[In- Censorinus. De die natali. *** 1497. ff. 
37-38.] 
Poggius, Joh. Franciscus. [Facetiarum 
liber.] [F. ia. tit.] Pogii florentini oratoris 
I clarissmi fiacetiarum [sic] .."...'.. | [F. 
ib:] POGII FLORENTINI ORATORIS 
CLA|RISSIMI FACFTIARUM [sic] 
LIBER INCIPIT FELICITER. | [F. 58*. 
I. 26:] fabulandiq[ue] consuetudo sublata. 
I Finis I [F. $8 b . Device, with motto, 
CEST MON DESIR DE DIEV. SER- 
VIR. POUR. ACUERIR SON BON 
PLAISIR] [58] ff. 4 . 
[Paris, Le Noir, circa 1495.] 
[Copinger no. 4787.] 

Only two other copies 0/ this edition known. Ac- 
cording to Census of the Bibliographical Society 
this is the only copy in America. 

[Prognosticon de mutatione aeris. Ac- 
ced: Hippocratis Iibellus de medicorum 
astrologia, a Petro de Abano in Latinum 
traductus.] [F. 1 blank.] [F. 2a:] Opus- 
culu[m] reperto[r]ii p[r]onosticon in | mu- 
tationes aeris tarn via astrologica | q[uam] 
metheo[r]oIogica vti sapie[n]tes expe |- 
rientia comperientes voluerunt p[er]- 
q[uam] | vtilissime o[r]dinatu[m] incipit 
sidere felici | [et] p[r]imo p[r]ohemiu[m]. 
I [F. 50a:] Hyppocratis Iibellus de medi- 
co[r]u[m] astrologia finit: a Petro de 
abbano | in Iatinu[m] traduct[us]. Im- 
p[r]essus est arte ac diligentia mira Er- 
hardi Rat- | dolt de Augusta Imperante 
inclyto Iohanne Mocenico duce Uene- | 
to[r]u[m]: Anno salutifere incarnationis. 
1485. I Uenetijs. | 

50 ff. 4 . Venetiis, Erhardus Ratdolt, 1485. 

[Hain no. 13393.] 



Publicius, Jacobus [Ars memorativa] [F. 
1 a. tit:] §Jacobi publicii in arte memo[r]ie. 
I Item Regimen sanitatis salernitanum 
nee non j magistri Arnoldi de noui 
villa. I §Venundantur parrhisiis in vico 
sancti Iacobi ab AIexand[r]o aliatte e 
regione diui benedicti. | [F. 12a:] Explicit 
ars memoratiua | Iacobi publicii. | [F. 
12b:] Regimen sanitatis | [F. 18b:] §Hoc 
opus optatur quod flos medicine vocatur. | 

18 ff. 4 . Parisiis, Alexander Aliatte, [circa 
1490.] 

[Not in Hain.] 

Publicius, Julius [Artis oratoriae epitome; 
ars epistolaris et ars memoriae.] [F. 1 
blank. F. 2a (c. sign. A) :] ORATORIAE 
ARTIS EPITOMA:***INSUPER ET 
PERQUAM FACILIS MEMO- 1 RIAE 
ARTIS MODUS *** [F. 51b:] Iacobi Pub- 
licii Florentini ars memori[a]e feliciter 
incipit I *** [F. 66b:] Erhardus Ratdolt 
auguste[n]sis ingenio miro & arte p[er] 
polita im- | pressioni mirifice dedit. 1485. 
pridie calen[das]. februarii. Venetiis. | 

66 ff. il. 12 wood-cuts. 8°. Venetiis, Ratdolt, 

1485. 
[Hain no. 13546.] 

Duke of Sussex's copy. Most beautiful book 
printed by Ratdolt. 

Purbachius, Georgius Theoricae nouae 
planetar[um]. 

[In- de Sacro Bosco, J. Sphaera mundi. 1490. 
ff. 3ob-47b.] 

[QUAESTIONES NATURALES ANTIQUORUM 
PHILOSOPHORUM DE DIVERSIS GENERIBUS 

ciborum et potus] [F. i a. tit:] Questiones 
naturales anti- | quo[r]um philosopho- 
[r]um tractantes de diuersis | generibus 
cibo[r]um et potus *** [F. 10a:] Imp[r]es- 
sum in Colonia apud conuentu[m] p[r]e 
I dicato[r]um per me Co[r]neIium de 
Zyrychzee | 

10 ff. il. 4 . Coloniae, Cornelius de Zyrychzee, 

[circa 1500.] 
[Reichling no. 706.] 



72 



Annals of Medical History 



Rabanus Maurus, Magnentius [Opus de 
universe] [F. ia:] Epistola Rabani ad 
Iudouicum regem | inuictissimufm] [et]c. 
incipit foeliciter. | [F. 166b. col. 2:] vna | 
potestas vna coop[er]atio est. | 

168 ff. F°. [Argentorati, Adolf Rusch, circa 

1467.] 
[Hain no. 13669.] 

Regiomontanus, Johannes Disputationum 
Ioannis de monte regio contra cremonen- 
sia in planetarum | theoricas deliramenta 
praefatio. | 

[In- de Sacro Bosco, J. Sphaera mundi. 1490. 
ff. 22a~3oa.] 

Rhazes, [Abu Bekr Muhammed Ben Zak- 
hariah Alraci] [Liber ad Almansorem, 
etc.] [F. 1 a:] Contenta in hoc volumine. | 
§Liber Rasis ad aImanso[r]em. *** [F. 
159b:] § Explicit hoc opus mandato [et] 
expensis nobilis viri do | mini Octauiani 
Scoti Ciuis Modoetiensis. per Bone | turn 
Locatellum Bergomensem. 1497. die sep- 
timo me[n]- | sis Octob[r]is. | 

159 ff. F°. [Venetiis], Bonetus Locatellus for 
Octavianus Scotus, 1497. 

Hain no.]3i 893.] 

Rhazes, [Abu Bekr Muhammad Ben Zak- 
hariah Alrazi] [Liber nonus ad Alman- 
sorem cum commentario Sillani de Nigris.] 
[F. 1 a:] AImanso[r]is liber Nonus | cum 
expositione Syllani. | [F. 2a:] §Incipit non- 
us liber AImanso[r]is cum expo | sitione 
eiusdem clarissimi docto[r]is Syllani de | 
nigris de Papia. | [F. 89b:] §ExceIIen- 
tissimi doctoris domini Petri de | Tussig- 
nano Recepte super nono aIma[n]soris 
fe I Iiciter finiunt Impresse Uenetiis per 
Otinum | Papiensem de Luna. Anno salu- 
tis. M.cccc I xcvii. xii. Cal[endas]. Augus- 

-4-y I *t**I"-l* 

89 ff. F°. Venetiis, Otinus Papiensis de Luna, 

1497. 
[Hain no. 13897.] 

Rhazes, [Abu Bekr Muhammad Ben Zak- 
hariah Alrazi] [Tractatus decern medici. 
Eiusdem liber divisionum et alii tractatus. 



Galieni, Hippocratis, Joannis (Mesue) 
Damasceni aliorumque opuscula] [F. ia:] 
Abubecri rasis filij zacharie liber. | *** 
[F. 218 a:] Imp[r]essum Mediolani per 
p[r]udentes | opifices Leonardum pachel 
[et] Uldericum | scinzcenceller Teuthoni- 
cos anno a natiuita | te domini Millesimo 
quadringentessimo | octuagessimo p[r]i- 
mo. xvi. k[a]I[end]as martias. | 

218 ff. F°. Mediolani, Leonardus Pachel et 
Uldericus Scienzenceller, 1481. 

[Hain no. 13891.] 

Rodericus Sanctius Bishop of Zamora. 
[Speculum vitae humanae.] [F. ia:] Ad 
sanctissimu[m] et B. d[omi]n[u]m. *** 
Paulum secu[n]dum | pontificem maxi- 
mu[m]. liber incipit dictus spec[u]I[u]m 
vite I humane. *** [F. 125b:] Finit liber 
dictus Speculu[m] vite humane. *** rec- 
ta[m] [et] his specula[n]di | p[re]scribendo 
norma[m] a Ginthero zainer ex Reutlin- 
gen I ciui progenito. vrbe aut[em] co[m]- 
manenti Augustensi: arte | impressoria in 
mediufm] feliciter deditus: Anno a partu 
I virginis salutifero Milesimo quadringen- 
tesimo sep | tuagesimo primo: ydus vero 
Ianuarias tercio. [Register.] 

[128] ff. F°. Augsburg, Zainer, 1471. 

[Hain no. 13940.] 

Rare and beautiful specimen from the first press 
at Augsburg. 

Roland of Parma. [De curatione pestifero- 
rum apostematum.] [F. ia:] Rolandi 
capelluti Chrysopolitani Philosophi. par- 
me[n] | sis: ad Magistru[m] Petru[m] de 
gnala[n]dris de parma: Cy | rugicu[m] op- 
timum: Tractatus de curat[i]o[n]e pesti- 
feroru[m] | apostematum. Incipit feliciter. 
[ [Ad finem:] Rome impressum p[er] In- 
geniosu[m] viru[m] Ma | gistrufm] Vdal- 
ricu[m] gallu[m] de Almania. | 

6 ff. 4 . Romae, Udalricus Gallus, [circa 147 1.] 

[Hain no. 4374.] 

RUSTICHELLI, PlETRO ToRRIGIANO [Com- 

mentum in Galeni Iibrum, qui Microtech- 
ni intitulatur.] [F. ia. tit:] Tursani monaci 



Incunabula 



73 



plus[que] [com]mentum in | microtegni ga- 
Iieni | Cum questione eiusd[e]m de ypos- 
tasi. [F. 2a (c. sign. A. 2 et n. 2) :] Trusiani 
Monaci cartusiensis plus[que] co[m]men- 
tu[m] in Iibru[m] | Galieni. qui microtechni 
in titulatur. [F. 1 36b. col. 2 :] Explicit Com- 
mentum Turisani in Iibrum Galieni qui | 
microtechni inscributur. [Acced. tab. et 
quaestio de ypostasi. F. 141b. col. 2.:] 
Turisani de FIore[n]tia, explicit de ypos- 
tasi tractus. tria | habens capitula. | Uene- 
tiis impressus ma[n]dato [et] expe[n]sis 
nobilis Uiri Do | mini Octauiani Scoti 
Civis Modoetiensis. 1498. pridie | ydus 
apriles. Per Bonetu[m] Locatellufm] Ber- 
gomensem. | 

141 ff. F°. Venetiis, Bonetus Locatellus for 
Octavius Scotus, 1498. 

[Hain no. 15684.] 

de Sacro Bosco, Joannes [Sphaera mundi.] 
[F. ia. tit.:] SPHARA I MUNDI. I [F. 
ib. icon xyl. F. 2a. c. sign, a ii:] SPHAE- 
RAE mundi compendium foeliciter in- 
choat. I *** Co[n]tra- | q[ue] cremone[n]- 
sia i[n] planetar[um] theoricas delyra- 
menta Ioan[n]is de mo[n]teregio disputa- | 
[ti]o[n]es *** Nee no[n] Georgii purbachii: 
i[n] eoru[n]de[m] motus planetar[um] ac |- 
curatis. theoricae. *** [F. 47b:] Hoc 
quoq[ue] sideralis scientie singulare opus- 
culum Impressum est Venetiis man- | dato 
& expensis nobilis uiri Octauini scoti 
ciuis modoetiensis Anno Salutis ] M.cccc- 
Ixxxx. quarto nonas octobris. | [F. 48a:] 
REGISTRUM. | *** FINIS. | [Rubra 
typ. insig. c. Iitt. OSM.] 

48 ff. ii. 1 wood-cut. 8°. Venetiis, [Bonetus 

Locatellus], 1490. 
[Hain no. 141 13.] 

Salernum, School of [Regimen sanitatis 
Salernitanum] [F. 1 blank.] [F. 2a:] Incipit 
regime[n] sanitatis salernitanu[m] excel- 
Ientissimu[m] p[r]o [con]ser | uatio[n]e san- 
itatis toti[us] humani generis *** [F. 80b :] 
Regimen sanitatis. 

80 ff. 4 . [Lugduni, n. pub., circa 1485.] 

[Copinger no. 5058.] 



Salernum, School of [Regimen sanitatis 
Salernitanum]. [F. ia. tit.:] Regimen sani- 
tatis [F. 2a:] § Incipit regimen sanitatis 
salernitanu[m] *** Arnaldo de villa noua 
***M.CCCC. octuagesimo. *** [F. 83b:] 
Hoc opus optatur q[uod] flos medicine 
vocatur. | §Tractatus excellentissimus qui 
deregiminesa | nitatis nuncupatur. §Finit 
feliciter. | 

83 ff. 8°. [Montpellier], 1480. 

[Hain-Copinger no. 13747.] 

First dated edition — [Brunet.] According to 
Ebert and Choulant, the first edition. 

Salernum, School of [Regimen sanitatis 
Salernitanum.] [F. ia:] Regimen sanitatis 
salernitanu[m] necno[n] et | mag[ist]ri Ar- 
noldi [de] noua villa feliciter i[n]cipit| 
A[n]gIorum regi scripsit scola to | ta saler- 
ni: [F. 135a:] Explicit regimen sanitatis 
compositum seu ordi | natum a magistro 
Arnoldo de villa noua Cathalo | no om- 
nium medicorum viuentium Gemma. | 
135 ff. 8°. [Louvain, John of Westphalia, circa 

1480.] 
[Hain no. 13749.] 

Salernum, School of [Regimen sanitatis 
Salernitanum]. [F. 12b. c. sig. ciiii:] Regi- 
men sanitatis | §Regimen sanitatis saler- 
nitanum necnon et magi | stri Arnoldi de 
noui villa feliciter incepit [sic]. | [F. 18b. c. 
sig. ciiii:] §Hoc opus optatur quod flos 
medicine vocatur. | 
[In- Publicius, J. Ars memorativa. *** circa 
1490. ff. I2b-i8b.] 

Salernum, School of [Regimen sanitatis 
Salernitanum] [F. ia. tit:]REgimen sani- 
tatis Salerni | [F. 2a:] Regimen sanitatis 
Salernitanu[m] : necnofn] et ma= | gistri 
Arnoldi de noua villa feliciter Incipit. | 
[F. 87b:] Hoc opus optatur quod flos 
medicine vocatur | 

[88 ff. 4 . [Parisiis, Guido Mercator, circa 1484.] 

[Copinger no. 5063.] 

Salernum, School of [Regimen sanitatis 
Salernitanum] [F. 1 blank.] [F. 2a:] Regi- 
men sanitatis salernitanu[m]. necnon | 



74 



Annals of Medical History 



m[a]g[ist]ri Arnoldi [de] noua uilla. felici- 
ter i[n]cipit | *** [F. 136a:] Explicit regi- 
men sanitatis compositum seu ordi[n]a |- 
tum a magistro arnoldo de villa noua 
Cathalono o[m] | nium medicorum viuen- 
tium gemma. | 

136 fF. 4 . [Lovanii, Joh. de Westfalia, circa 
1485.] 

[Copinger no. 5056.] 

Salernum, School of [Regimen sanitatis 
Salernitanum] [F. ia. tit:] Regimen sani- 
tatis I [F. 2a:] Incipit regime[n] sanitatfis] 
salernitanu[m] excelle[n]tissimu[m] p[ro] 
[con]ser | uatione sanitat[is] *** [F. 80a:] 
Hoc opus optatur q[uod] flos medicine 
vocatur. | Tractatus qui de regimine sani- 
tatis nu[n]cupat[ur] | Finit feliciter. Im- 
p[r]essus Argen. Anno d[omi]ni | M.cccc- 
xcj. In die sancti Thome ca[n]tuarien[sis]. | 

80 fF. 4 . Argentorati, n. pub., 1491. 

[Hain no. 13758.] 

Genuine edition. 

Salernum, School of [Regimen sanitatis 
Salernitanum] [F. ia. tit:] Regimen sani- 
tatis cum ex- I positio[n]e magistri Arnal 
I di de villanoua | [F. 64b:] Hoc opus 
optatur quod | flos medicine vocatur. | 
Tractatus qui de regimine sanitatis nun- 
cupatur: finit | feliciter. Imp[r]essus ar- 
gen. anno domini. M.cccc.xci. | In die 
sancti Thome cantuariensis. | 
64 fF. 4 . Argentorati, n. pub., 1491. 
[Hain no. 13757.] 

According to Proctor this edition is a Venetian 
reprint oj the genuine edition printed at 
Argentorati. 

Salernum, School of [Regimen sanitatis 
Salernitanum] [F. ia. tit:] REGIMEN 
SA= I nitatis cu[m] expositione magistri 
Arnal- | di de villanoua Cathellano Noui- 
ter imp[r]essus. | [F. 82b:] HOc opus opta- 
tur: quod I Flos medicine vocatur. | 

82 fF. 4°. [Venetiis, n. pub., circa 1500.] 

[Copinger no. 5052.] 

Salernum, School of [Regimen sanitatis 
Salernitanum.] [F. ia. (c. sign, ai):] 



Regimen sanitalis [sic] salernitanufm] nec- 
no[n] [et] | m[a]g[ist]ri Arnoldi de noua villa 
Feliciter incipit. | [F. 136b. (c. sign, sv):] 
Hoc op[us] optatur q[uod] flos medicine 
vocat[ur]. [F. 137 blank. F. 138a. (c. 
sign, ti):] Incipit liber de co[n]seruatione 
co[r]p[or]is de re | gimine sanitatis.*** [F. 
1 66b. (c. sign, yv) :] Explicit regimen sani- 
tatis compositum | seu o[r]dinatum a mag- 
istro Arnoldo de villa noua Cathalano 
omnium medicorum viuen | tium Gem- 
ma. I 

166 fF. 8°. [Coloniae, circa 1480.] 

[Hain no. 1375 1.] 

de Saliceto Placentinus, Gulielmus 
[Summa conservationis et curationis] [F. 
1 blank wanting.] [F. 2a:] In nomine 
domini nostri | iesu Ch[r]isti [et] matris 
eius virginis Marie *** [F. 178a:] Im- 
p[r]essu[m] Uenetiis Anno domini. M.- 
cccclxxxx. I die. viij. mensis Madij *** 
FINIS LAUS DEO | Finito Iib[r]o refera- 
mus gratia Ch[r]isto. | 

178 fF. F°. Venetiis, [Johannes et Gregorius de 

Gregoriis], 1490. 
[Hain no. 14145.] 

Savonarola, Giovanni Michele [Canoni- 

ca de febribus] [F. ia. tit:] Practica Sauon- 

arole De Febribus: [F. 2a:] Canonica de 

febribus magistri Michaelis sa | uonarole 

ad Raynerium siculum incipit. | [F. 1 1 ib:] 

Ad Iaudem omnipote[n]tis dei: ac gloriose 

eius I matris Marie *** Venetiis imp[re]s- 

sum p[er] Christo- | ferum de pe[n]sis de 

Mandello anno Domini. MC | CCCL- 

XXXXVI. die. xvi. Octobris. Laus deo. | 
*** 

in fF. F°. Venetiis, Christophorus de Pensis 

de Mandello, 1496. 
[Hain no. 14488.] 

Savonarola, Giovanni Michele [De bal- 
neis et thermis naturalibus omnibus 
Italiae] [F. ia. tit:] SAVONAROLA DE 
OMNI- 1 BVS MVNDI BALNEIS. | [F. 
32b:] Impressum Venetiis per Cristo- 



Incunabula 



75 



feru[m] de Pensis | de Mandello die. xx. 
Nouembris. | *** 

32 ff. F°. Venetiis, Christophorus de Pensis de 
Mandello, [1497.] 

[Hain no. 14492.] 
Savonarola, Giovanni Michele [Opus 
medfcinae, seu practica de aegrftudinibus 
de capite usque ad pedes] [F. ia. tit:] 
P[r]actica Ioannis Michaelis Sauonarole. | 
[F. 2a:] §Ad Sigismundu[m] PoIcastru[m] 
Uiru[m] quippe ingeniosissi- | mum operi 
p[r]actico deditufm] amicum optimum. | 
[F. 7a:] §Ioannis Michaelis Sauonarole 
Patauini clarissimi | ac sui te[m]po[r]is 
medico[rum] p[ri]ncipis opus p[r]acticum 
in sex tra- | ctatus diuisum feliciter in- 
cipit. I [F. 282a:] *** Imp[r]essum vene- 
tijs ma[n] | dato [et] expensis. Nobilis 
Uiri d[omi]ni Octauiani Scoti Ci- | uis 
Modoetie[n]sis. 1497. Quinto Kal[endas]. 
Iulias I Per B[o]netum Locatellum Ber- 
gomensem. | 

282 ff. F°. Venetiis, Bonetus Locatellus for 
Octavianus Scotus, 1497. 

[Hain no. 14484.] 

Savonarola, Giovanni Michele [Summa 
de pulsibus, urinis et egestionibus] [F. ia. 
tit:] SAVONAROLA DE PVLSIBVS | 
VRINIS: ET EGESTIONIBVS. | [F. 
44a:] Impressum Venetiis per Magistrum 
Cristofo- I rum de Pensis de Mandello. 
M.cccc.Ixxxxvii. die | decimo mensis Feb- 
ruarii | 

44 ff. F°. Venetiis, Christophorus de Pensis de 

Mandello, 1497. 
[Hain no. 14491.] 

Savonarola, Girolamo [Ricetto contra 
morbo spirituale.] [F. ia:] §Frate Hierony- 
mo da Ferrara del ordine de predicatori 
a I suoi dilecti fratelli in Christo Iesu 
gratia pace & conso | Iatione dello spirito 
sancto. I [F. 2a. 1. 10:] §In conuentu 
sancti Marci Florentie. xv. Iulii. M.cccc. 
I Ixxxxvii. I Laude di fra Hier. ad infiam- 
mare il core al diuino amore | *** 

2 ff. 4 . [Florentiae, Bartholomaeus de Libris, 
1497.] 

[Hain no. 14371.] 



Scanarolus, Antonius [Disputatio de mor- 
bo Gallico] [F. 1 a. tit:] Disputatio Utilis 
de mor | bo gallico Et opinio [n] is | Nicolai 
Leo[n]iceni Co[n] | firmatio co[n]tra Ad | 
uersarium Ean | de[m] opinione[m] oppug- 
nan | tern. | [F. 16a:] Explicit disputatio 
Vtilis de Morbo Gallico | Impressu[m] 
Bononiae, Die uero. xxvi. | Martii. M.- 
CCCC I LXXXX. I VIII. I § I 

16 ff. 4 . Bononiae, [Benedictus Hectoris], 1498. 

[Hain no. 14505.] 

Schrick, Michael [Von den ausgebrannten 
Wassern] [F. 1 blank.] [F. 2a:] [H]Ienach 
steend verzeichnet die au[ss]geb[r]anntten 
I wasse[r] *** [F. 3a:] [H]Ie nachuolget 
ein nuczliche matery von man- | gerley 
au[ss]geb[r]an[n]tten wassern *** [F. 15b:] 
§Ged[r]iickt vnnd vollenndet von Io- 
| hanni Bamler zii Augspurg. An sant | 
Margarethen abent. Anno domini. | M.- 
cccc.Ixxxij. jar. [et]c. [F. 16 blank.] 
16 ff. F°. Augsburg, Johannes Bamler, 1482. 
[Copinger no. 5318.] 

Scott, Sir Michael [Liber physionomiae.] 
[F. 1 a (c. sign. aii-2b tab.):] [F. 3a (c. 
sign, aiiii):] Incipit Liber Phisionomiae : 
quern compi | Iauit magister Michael 
Scotus. *** [F. 46b:] Michaelis Scoti de 
procreatione & hominis Phi | sionomia 
opus feliciter finit. | 

46 ff. 12°. n. p., n. pub., [circa 1490.] 

[Hain no. 14546.] 

Scott, Sir Michael [Liber physionomiae] 
[F. 1 a. tit:] Liber phisionomie | magistri 
michaelis | scoti. | [F. 3a:] [I]Nci | pit Ii |- 
ber phisi= | onomie: | *** [F. 34a:] Mi- 
chaelis Scoti de p[ro]creatio | ne et homin- 
is phisionomia | opus feliciter finit. | 

34 ff. 4°. n. p., n. pub., [circa 1489.] 

[Hain no. 14543.] 

Imperfect, ff. 4-5 missing. 

Scott, Sir Michael [Liber physionomiae.] 
F. 1 a. (c. sign, ai):] (p)RIMA pars Iibri 
huius Cap. i. | [F. 4 (c. sign, aiiii):] 
(i)NCIPIT Liber Phisionomiae: que[m] | 
compilauit magister Michael Sco- | tus 



7 6 



Annals of Medical History 



*** [F. 77b. (c. sign, kvi) :] Michalis Scoti 
de procreatione & hominis | Phisionomia 
opus feliciter finit. | M.CCCC.LXXVII. 

77 ff. 12 . [Venice, Jacopo de Fivizano], 1477. 

[Hain-Copinger no. 14550.] 

First dated edition of the earliest printed work on 
generation. 

[SCRIPTORES ASTRONOMICI VETERES.] [pt. I 

wanting.] [pt. 2. f. ia. (c. sig. A) :] MARCI 
MANILII ASTRONOMICON | AD 
CAESAREM AVGVSTVM | LIBER 
PRIMVS. I [pt. 2. f. 124a.] ARATI 
PHAENOMENON RVFO | FESTO 
AVIENIO PARAPHRA | STE, | *. FIN- 
IS.* I [pt. 2. f. 125a:] *** ARATI SOLEN- 
SIS PHAENOMENA | CVM COM- 
MENTARIIS. I [pt. 2. f. 185a:] PROCLI 
DIADOCHI SPHAERA, ASTRONOMI 
I AM DISCERE INCIPIENTIBVS 
VTILLISSIMA. I THOMA LINACRO 
BRITANNO INTER- | PRETE, AD 
ARCTVRVM, CORNV|BIAE, VAL- 
LIAEQVE ILLVSTRIS | SIMVM 
PRINCIPEM. I [pt. 2. f. 192a:] Venetiis 
cura, & diligentia Aldi Ro. Mense octob. 
I M. ID. Cui concessum est *** 

pt. 2. 192 ff. il. F°. Venetiis, Aldus Manutius, 
1499. 

[Hain no. 14559.] 

Serapion, Joan. [Breviarium medicinae.] 
[F. 1 a. tit:] P[r]actica Jo. Serapionis 
dicta I b[r]euiarium. | Liber Serapionis de 
simplici | medicina. | Liber de simplici 
medicina. dictus | circa instans P[r]actica 
platearij. | [F. 211b:] §Imp[r]essum Uene- 
tijs mandato [et] expensis nobilis viri | 
domini Octauiani Scoti Ciuis Modoetien- 
sis per Bo- 1 netufm] LocateIIu[m] Ber- 
gomense[m]. 17. kal. Ianuarias. 1497 [sic]. | 

212 ff. F°. Venetiis, Bonetus Locatellus for 
Octavianus Scotus, 1497. 

[Hain no. 14695.] 

Serapion, [Joan.] the younger. [Liber Sera- 
pionis aggregatus in medicinis simplici- 
bus.] [F. 1 a vacat] [F. ib-2b tables.] 
[F. 3a vacat.] [F. 4a (cum sig. a2):] 
Liber Serapionis aggregatus in medi | 
cinis simplicibus. Tra[n]slatis Symonis 



I a I nuensis interprete Abraam iudes tor- 
tuosi I ensi de arabico in Iatinu[m] Inquit 
Serapio. | [F. 136a. col. 2:] Opus impres- 
sum Venetiis per magi | strum Reynal- 
du[m] de Nouimagio AI [ manum. Anno 
domini. MccccLxxix | die octauo mensis 
Iunii. [Register.] 

[2], [133] ff- F°. Venetiis, Raynaldus de Novi- 
magio, 1479. 

[Hain no. 14692.] 

Serenus Samonicus, Quintus [Liber medi- 
cinae.] [F. ib:] Sulpitius Verulanus ad | 
unumquemq[ue] Iectorem: | *** [F. 2a:] 
QVINTI SERENI SAMMONICI | LI- 
BER I *** [F. 25b:] Q. SERENI SAM- 
MONICI I FINIS: I *** 

26 ff. 8°. [Romae, 1490.] 
[Hain no. 14698.] 

Sermoneta, Johannes [Quaestiones super 
Iibb. aphorismorum et super lib. Tegni.] 
[F. 1 a:] Questiones subtilissime Johannis 
I Sermonete super Iibfrorum] affo[r]ismo- 
[rum] I Eiusdem super Iib[r]um tegni. | 
[F. 72b:] §Uenetijs vero imp[r]essa man- 
dato et expensis Nobilis | Uiri D[omi]ni 
Octauiani Scoti Ciuis Modoetiensis. 1498. 
I p[r]idie Kal. ap[r]iles. Per Bonetum 
Locatellum Ber- | gomensem. | 

73 ff. F°. Venetiis, Bonetus Locatellus for 
Octavianus Scotus, 1498. 

[Hain no. 14701.] 

Silvaticus, Matheus [Liber pandectarum 
medicinae] [ff. 1-7 wanting.] [F. 8a:] 
Liber pa[n]dectaru[m] | medicine: omnia 
medicine simplicia co[n] | tinens: quern 
ex omnibus antiquo[r]um | Iib[r]is aggre- 
gauit eximius artium *** [Ad finem :] Opus 
pandecta[rum] medicine emenda- | turn 
*** Et imp[r]essu[m] p[er] Her- | manum 
Iichtenstein coloniensem p[r]o- 1 batissi- 
mum Iib[r]arie artis exacto[r]em Uin | 
centie | 

321 ff. F°. Vincentiae, Hermannus Liechten- 
stein, [circa 1478.] 

[Hain no. 15 193.] 

Imperfect, ff. 1-7 missing. 

Silvaticus, Matheus [Liber pandectarum 
medicinae] [F. 1 blank.] [F. 2a:] Matheus 



Incunabula 



77 



mo[r]etus B[r]ixiensis: Ad reue- | rendis- 
simum in ch[r]isto patrefm] ac dominu[m] 
Dominum Franciscufm] de gonzaga Car- 
di | nalem Mantuanum ac Bononie Iega- 
tu[m]. | [F. 7a:] Liber pandectarum medi- 
cine omnia medicine simplicia contine[n]s : 
quern ex om | nibus antiquo[r]um Iib[r]is 
aggregauit exi | mius artium & medicine 
docto[r] Mathe | us siluaticus ad serenis- 
simum sicilie rege[m] | Robertum. | [F. 
308a:] [Con]disi quid est lege Iiteram 
condes. | 

308 ff. F°. [Argentorati, Adolf Rusch, circa 
1470.] 

[Hain no. 15 192.] 

Silvaticus, Matheus [Liber pandectarum 
medicinae] [F. ib:] Matheus mo[r]etus 
B[r]ixensis ad reuerendissimum in ch[r]isto 
patre[m] ac Dominu[m] D[omi]n[u]m fran- 
ciscufm] I de gonzaga Cardinalem Man- 
tuanu[m] : ac Bononie Iegatum. | [F. 206a:] 
Opus pandectarum medicine emendatum 
*** Et i[m]p[r]es | sum Uenetijs arte et 
ingenio Marini saraceni | Anno d[omi]ni. 

M.cccclxxxviij. xiiij. kal. Iunij. | FINIS | 
**** 

206 ff. F°. Venetiis, Marinus Saracenus, 1488. 
[Hain no. 15200.] 

Silvaticus, Matheus [Liber pandectarum 
medicinae] [F. ia. tit:] Opus pandectarum 
Matthei silua | tici cum Simone ianuense 
et cu[m] I quotationibus aucto[r]itatum 
Plinii galieni | [et] aIio[r]u[m] aucto[rum] 
I in Iocis suis | [F. 154a:] Per Bernardi- 
nu[m] stagnin de | Tridino mo[n]tifferrati. 
M. I cccc.Ixxxxix. Die ve- | ro. xxvij. Mar- 
cij I Uenetijs. | 

154 ff. F.° Venetiis, Bernardinus Stagninus de 
Tridino de Monteferrato, 1499. 

[Hain no. 15 199.] 

Taddeo Fiorentino. Libellus de sanitate. 
[In-de Nursia, B. Libellus de conservatione 
sanitate. *** 1477. pp. 265-279.] 

Tartaretus, Petrus [Totius philosophiae 
necnon metaphysicae Aristotelis exposi- 
tio] [F. 1 wanting.] [F. 2a:] Questiones 
admodu[m] subtiles et | vtiles cu[m] 



medulla totius materie ar | tium quat- 
tuo[r] Iib[r]o[rum] sententia[rum] *** [F. 
147a:] §Fructuosum facileq[ue] opus in- 
troducto[r]ium | in Iogicam philosophiafm] 
*** Imp[r]essu[m] v[er]o | cura [et] indus- 
tria Nicolai vvolff alemani. Anno | [Christ]- 
iane salutis. 1500. die vero. 10. decem- 
b[r]is. I 

v. 2. 150 ff. 4°. [Lugduni], NicoIausWoIff, 1500. 

[Hain no. 15345.] 

Theobaldus, bishop [Physiologusdenaturis 
duodecim animalium]. [F. ia. tit. :] Phisiol- 
ogus theobal | di episcopi de naturis | 
duodecim animalium. | [F. 2a :] ( ) Uoniam 
[secundu]m platonem nihil est [or]tu[m] 
sub sole I *** [F. 20a:] Finit phisiologus 
de duodecim naturis a[n]i[m]alium. | 

20 ff. 8°. n. p., n. pub., [circa 1480.] 

[Hain no. 15467.] 

First edition. 

Theophrastus, Eresius [De historia et 
causis plantarum.] [F. 2a (cum sign, aaa 
et n. 1) Incipit Theophrasti. hist, plan- 
tarum; deinde ejusd. Iibb. de causis 
plantarum, qui term. f. 227a (c. n. 226) :] 
[In- Aristoteles Opera graece. 1497. v. 4. ff. 
2a-227a.] 
[Hain no. 1657.] 

Theophrastus, Eresius [De historia et 
causis plantarum] [F. 1 blank.] [F. 2a:] 
THEODORI GRAECI THESSALONI- 
CENSIS AD NICOLA | VM QUINTVM 
PONT. MAX. I [F. 4 b:] THEOPHRASTI 
DE HISTORIA PLANTARVM LIBER 
PRI I MVS PER THEODORVM GA- 
ZAM IN LATINVM EX GRAE | CO 
SERMONE VERSVS. | [F. 156a:] IM- 
PRESSVM TARVISII PER BAR- 
THOLOMAEVM CON | FALONER- 
IVM DE SALODIO. ANNO DOMINI. 
M.CCCC I LXXXIII DIE XX. FEB- 
RVARI. I 

156 ff. F°. Tarvisii, Bartholomaeus Confalon- 

erius de Solodio, 1483. 
[Hain no. 15491.] 
de Thienis, Gaietanus [RecoIIectae super 
VIII Iibb. physicorum Aristotelis.] [F. ia:] 
Gaietani [de] thyenis vince[n]tini philo- 



78 



Annals oj Medical History 



sophi | preclarissimi r[e]coI[I]ecte sup[er] 
octo Iibros phy | sico[rum] Aristotilis [sic] 
incipiunt feliciter. [ [F. 94a:] Finis recollec- 
taru[m] Gayetani de tyenis | phylosophi 
preclarissimi f[elicite]r Iibris octo phy- 
| sicorum a[ristoteIis] ad Iaudem dei amen. 
[Register. In fine:] Deo gratias | 

96 ff. F°. [Tarvisium, Hessen, 1474.] 

[Hain no. 15496.] 

Important and little known work by the third 
printer in Treviso, who printed only two works. 

de Tornamira, Johannes [Clarificatorium 
super nono Almansoris cum textu Rhasis.] 
[F. 1 a. tit:] Incipit darificato[r]iu[m] 
ioha[n]nis de to[r]namira | super nono al- 
ma[n]so[r]is cu[m] textu ipsius Rasis. | [F. 
160b:] P[r]eclarissimi opus Ioha[n]nis de 
to[r]namira do= | cto[r]is famosissimi *** 
imp[re]ssum Iug[duni]. p[er]. Ioha[n]nem 
trechsel | alemanu[m] artis imp[r]esso[r]ie 
mag[ist]r[u]m Anno n[ost]re sa | Iutis Mil- 
Iesimoquadringe[n]tesimo nonagesimo | 
die v[er]o decimaseptima me[n]sis Iunij 
finit feliciter. I [F. 161.] Tabula. | [F. 
162a.] Epistola. I 

162 ff. 4 . Lugduni, Johannes Trechsel, 1490. 

[Hain no. 15551.] 

[Tractatus de vino et eius proprietate] 
[F. 1 a blank.] [F. ib:] §Genus hominu[m] 
hac nostra etate multis Iaborare | *** [F. 
2a. 1. 7:] §Tractatus de uino & eius pro- 
prietate. I §De uindemiis Capitulum pri- 
mum. I [F. 8b:] Finis. | 

8 ff. 4 . [Romae, Johannes Besicken et Sigis- 

mundus Mayer, circa 1490.] 

[Reichling no. 351.] 

Valescus de Taranta. [De epidimia et 
peste.] [F. 1 a:] Incipit tractatus de epidi- 
mia et peste | domini ualasti de tarenta 
artium et medicine | docto[r]is excellen- 
tissimi Prologus | [F. 20a:] Et sic est finis 
totius tractatus Deo gracias | 

20 ff. 4 . n. p., [circa 1475.] 

[Hain no. 15245.] 

Valescus de Taranta. [De epidimia et 
peste] [F. 1 a:] Incipit tractatus de epidi- 
mia [et] peste | domini valasti de tarenta: 
artiu[m] [et] me | dicine doctoris excel- 



Ientissimi p[ro]Iog[us] | [F. 14a:] Finis 
huius. Deo gratias | 

14 ff. F°. [Argentorati, Martinus Flach, circa 
i_470.] 

[Hain no. 15244.] 

[Versehung von Leib, Seele, Ehre und 
Gut] [F. 1 a. tit:] Versehu[n]g leib sel | er 
vnnd gutt | [F. 2a:] In disem puch ist 
geschribe[n] ein | notturftige nutzliche 
trostliche | v[o]n der mass vo[r] vner- 
ho[r]te vn | terweisung zu uersechu[n]g 
eines | menschen leib sell er vnd gutt. | 
[F. 181a:] §Ged[r]uckt in der erentreichen 
I stat niirenberg in dem. Ixxxix. iare. | *** 
181 ff. il. 4 . Norimbergae, [Conrad Zeninger], 

1489. 
[Hain no. 160 19.] 

Vincentius Bellovacensis. [Speculum 

naturale] [v. 1. F. ia:] Incipit speculu[m] 

naturale Vincentij beluace[nsis] | fratris 

o[r]dinis p[re]dicatorum. Et p[r]imo p[ro]- 

Iogus [de] I causa suscepti op[er]is et eius 

materia. P[r]imu[m]. | [v. 2. F. 327b:] 

perstricta sunt, sed Iatiore in fine speculi 

hysto = I rialis. p[er]patescunt. Amen. | 

2 v. 368 & 328 ff. F°. [Argentinae, Adolf Rusch, 

I473-] 
[Copinger no. 6256.] 

Wirecker, Nigellus [Speculum stultor- 
um.] [F. 1 a. tit:] Brunellus in speculo 
stuIto[rum]. | [F. 2a:] [S]Uscipe pauca tibi 
veteris guillerme nigelli | Scripta, etc. [F. 
60b:] Brunelli in speculo stultorum | Finis 
adest feliciter. Amen. | 

[60] ff. 1 woodcut. 8°. [Leipzig, Kacheloven, 

1494.] 
[Hain no. 162 17.] 

Zeno, Antonius [De natura humana.] [F. 
1 a:] PETRUS Barbus polensis Sacrae 
Medicinae | Doctofr] ad Lecto[r]em. | *** 
[F. 58b:] §Imp[r]essus Anno d[omi]nicae 
natiuitatis. M.cccc. nonagesimo p[r]i | mo 
Ianuarij p[r]imo p[r]imus hie: per Diony- 
sium. Bononiensem | Uenetijs Iibellus est 
faustis ominibus. | *** 

58 ff. 4 . Venetiis, Dionysius Bononiensis, 1491. 

[Hain no. 16281.] 

Imperfect, v. 2 (sig. h-p)— Liber Mercurialis, 
missing. 



EDITORIALS 



RENE THEOPHILE HYACINTHE LAENNEC (1781-1826) 



Our cover illustration reproduces the 
features of the great internist to whom we 
owe the discovery of the stethoscope. Born 
at Quimper in Brittany, February 17, 1781, 
young Laennec grew to manhood during 
some of the most troublous years in the 
history of France. He studied medicine at 
Paris, receiving his degree of doctor in 
1804. While yet an undergraduate student 
he had published a report of the clinical 
and pathological findings in a case of car- 
diac disease with pulmonary complications. 
After graduation he continued his researches 
in pathological anatomy. In 1816 he be- 
came chief of service at the Neckar Hospi- 
tal, and in the same year he discovered the 
value of a hollow tube for the purpose of 
listening to the intrathoracic sounds and 
interpreting their significance. The value of 
percussion had been discovered by Auen- 
brugger in 1763, and it had been much 
employed by Corvisart, Laennec' s chief 
teacher. Auscultation of the chest by the ap- 
plication of the ear to its wall shocked the 
modesty of some physicians, and Laennec 
states that the filthy condition of patients 
in the hospitals made it repugnant to them, 



a curious reflection on hospital conditions 
at the time. Laennec was led to his great 
discovery by observing some children play- 
ing in the gardens of the Louvre, at listening 
to the transmission of sounds along pieces 
of wood. The next day he experimented in 
his ward at the Neckar Hospital, with a 
piece of rolled-up paper, and the stetho- 
scope was found. The early stethoscopes 
which he contrived were constructed of cy- 
Iindroids of glued paper, the later of wood. 
Laennec gave the name to the appliance, 
forming it from two Greek words, one 
meaning the chest, the other to observe or 
regard. He communicated the result of his 
observations before the Medical Society of 
Paris and to his students in his lectures and 
clinical teachings, but it was not until the 
summer of 181 9, just one hundred years 
ago, that he published his book, "De 
I'AuscuItation mediate ou Traite de diag- 
nostic des maladies des poumons et du 
coeur fonde principalement sur ce nouveau 
moyen d' exploration. " Seven years later, 
on August 13, 1826, at the early age of 
forty-five, he died in the quaint old Breton 
town in which he first saw light. 



HENRY E. HANDERSON'S "GILBERTUS ANGLICUS." 



The Cleveland Medical Library Associa- 
tion has not only rendered a graceful and 
well-deserved tribute to the memory of the 



late Dr. Henry E. Handerson, but has done 
a service to the profession in printing 
posthumously for private distribution his 



79 



8o 



Annals oj Medical History 



last contribution to medical literature, 
"Gilbertus Anglicus, a Study in Thirteenth 
Century Medicine." Dr. Handerson's article 
was originally designed for publication in 
the Cleveland Medical Journal, which un- 
fortunately ceased to exist before it could 
appear in its columns. The article was in 
type at that time. Shortly after Dr. Hander- 
son died and the editors of the Journal, 
with the consent of his family, turned it over 
to the Council of the Cleveland Medical 
Library, who, recognizing its value, have 
given it to the profession in its present form. 
To those who are aware of the erudition, 
critical ability, and accuracy of all of the 
author's previous work, this scholarly study 
of the "Compendium Medicinal" of Gilbert 
of England, the earliest complete work on 
general medicine by an English author, 
will be most welcome. Reviewing all the data 
available and adding materially to it, on 
the disputed points, as to the exact period 
of the life of Gilbert and the date at which 
his book was written, Handerson concludes 
that he was born about 1180, and that his 
book was written circa 1240. The contents 
of the Compendium are carefully reviewed 
and analyzed and the chief editions de- 
scribed. It is curious that the Compendium 
was held in such esteem by subsequent 
generations, that a printed edition of it 
appeared as late as 1608. Dr. Handerson's 
study will be found an invaluable addendum 
to the previous studies by Dr. J. F. Payne 
on this extremely interesting Father of 
English Medicine, and is stimulating as 
illustrating the method to be employed in 
such research. A word as to Dr. Handerson 
himself is due, largely because of the ex- 
cessive modesty with which he was wont 
to obscure his light. He was born in Ohio in 
1837 and began his medical studies at the 
Medical Department of the University of 



Louisiana, now Tulane University. The 
outbreak of the Civil War interrupted his 
course. Dr. Handerson enlisted in the 
Confederate Army, in which he finally 
achieved the rank of major. During the last 
year of the Rebellion he was a prisoner of 
war. When it was over he resumed his 
career as a medical student at the College of 
Physicians and Surgeons of New York, 
graduating in 1867. From that date until 
1885 he practiced his profession in New 
York City, then going to Cleveland, Ohio, 
where he remained until his death, which 
took place on April 23, 191 8. During the last 
two years of his life Dr. Handerson was total- 
ly blind. From a very early period Dr. Han- 
derson was deeply interested in the history 
of his profession. In 1883 he published 
The "School of Salernum," an historical 
sketch of medieval medicine, which is one 
of the best studies of the subject in English, 
but his magnum opus was his translation of 
Baas' "History of Medicine," which appear- 
ed in 1888. This is really much more than a 
translation, as the section dealing with the 
history of medicine in this country was 
really written by Dr. Handerson, and his 
notes on and revision of the German text 
add greatly to the value of the work. It is 
this book which is probably referred to 
more often than any other by medical 
men in the United States, when seeking 
light on matters connected with the history 
of medicine. Dr. Handerson was a pioneer 
worker in medical history in this country, 
and his work has never received sufficient 
recognition. The posthumous tribute of the 
Cleveland Medical Library Association is 
most just, and we can imagine no other 
offering to his memory which would have 
been more appreciated by Dr. Handerson 
himself. 

Francis R. Packard 



HISTORICAL NOTES 



CURRIE'S "JOURNAL" 



Dr. James Currie's manuscript "Jour- 
nal," sold, with many letters, at Sotheby's 
July 24th, 1918, has an interest for 
American readers. He is remembered as the 
first editor of the collected works of Burns, 
and as an early student of thermometry and 
hydro-therapy. 

As an apprentice lad at Cabin Point, 
Virginia (1 771-1776), his Tory principles 
were the cause of much trouble. After many 
difficulties, fully narrated in his "Life" 
(1831), he escaped. The "Journal," which 
with many letters was bought by the Public 
Library, Liverpool, is the diary of a voyage 
from Nixonton, N. C, to the Island of St. 
Martin, between September 19th and 
October 29th, 1776. It is not of much 
interest except as illustrating the careful 
self-education of a Scotch lad, and the 
horrid discomforts of a sea- voyage in those 
days. Much more interesting in the same 
volume is the manuscript of a letter which 
Currie wrote in defense of the Scotch in 
Virginia, and which appeared in Pinkney's 
Gazette on the 22d and 24th of March, 1775. 
For fifty years the Glasgow merchants had 
the lion's share in the tobacco trade of the 
colony, and their agents were slow in 
joining the newly formed continental asso- 
ciation, which made them unpopular, and 
led to abusive attacks. Currie writes in 
defense of his countrymen, posing as a 
resident of forty odd years. It is a remark- 
able letter ; for a young man (of nineteen, 
full of good sense and well expressed. 



The other letters sold related chiefly 
to Burns and his friends, many of which 
were used by Currie in writing the life of 
the poet. There were three letters from 
Benjamin Rush, in one of which he begs to 
inform his friend, Dr. Currie, that "peace, 
order, and plenty continue to pervade every 
part of the United States." It is satisfactory 
to know that the most important of these 
documents were secured by the Public 
Library, Liverpool. 

A few years ago a valuable group of 
Burns' manuscripts, which had belonged 
to Dr. Currie, were sold by the Liverpool 
Athenaeum, to which they had been pre- 
sented by his son. There was a public 
protest, but fortunately the purchaser, a 
citizen of Philadelphia, gave them to the 
Burns Library, Kilmarnock. 

Currie had deservedly a most successful 
career in Liverpool. His "Life" is well 
worth reading, and the two volumes of his 
"Medical Reports on the Effects of Water," 
1797, are full of original observations on the 
clinical use of the thermometer. In this 
study he was far in advance of his con- 
temporaries, who looked askance at his 
researches; so much so that the German 
translator quoted them in illustration of the 
backward state of English Medicine! Weir 
Mitchell, who had a great admiration for 
Currie, called my attention to his works, 
which he regarded as among the most 
valuable in English medical literature. 

William Osler 



81 



82 



Annals oj Medical History 
LOCAL HISTORY 



The histories of local institutions which 
have performed important functions in the 
life of any community and their compilation 
is a duty which, conscientiously performed, 
furnishes material of the greatest value to 
the historian, as well as stimulating local 
pride in their continuance and welfare. 

Two books of this character have recently 
been brought to our notice, both dealing 
with institutions situated in Boston, which, 
however, have exercised an influence for 
good far beyond the local confines of that 
city. "The History of the Boston Medical 
Library," 1 by Dr. John W. Farlow, its dis- 
tinguished Librarian, is of the greatest 
interest, not only to the medical profession, 
but also to all those concerned with library 
work. The Boston Medical Library was 
founded in 1805, by a group of prominent 
medical men belonging to the Medical 
Improvement Society of that city. In 1 826 
it was merged in the Boston Athenaeum. 
In 1875, chiefly owing to the activity and 
zeal of Dr. James R. Chadwick, it was 
determined by a number of physicians to 
once more establish a distinct medical 
library, the drawbacks to having collections 
of medical books merely as sections of other 
public libraries such as the Athenaeum and 
the Boston Public Library, having become 
manifest to all. Thus was begun the Boston 
Medical Library Association, the word 
Association not being dropped from its title 
until 1896. From its foundation it was 
successful. By the acquisition of medical 
libraries belonging to individuals, either by 
gift or bequest, and of libraries founded by 
other societies, such as the Medical Obser- 
vation Society, and the Massachusetts 
Medical Society, its growth soon assumed 
phenomenal proportions. As it grew, it 
became necessary to move its quarters from 
time to time, until finally, in 1901, the 

1 "The History of the Boston Medical Library," 
by John W. Farlow, M.D., privately printed 19 18. 



library was housed in the beautiful building 
which it now occupies on the Fenway. 
Besides having one of the largest collections 
of medical books in the world, it also con- 
tains a most valuable collection of medical 
medals, autographs, and pictures, and a 
number of very important medical incunab- 
ula. 

The other book records the great achieve- 
ments of the Humane Society of Massachu- 
setts 2 during one hundred and thirty years 
of beneficent activity. The Society was 
founded in 1785 by a group of well-known 
Bostonians to whom the work of the 
British Royal Humane Society had been 
described by an English traveler. Its first 
object was the resuscitation of persons 
drowned or suffocated, for which purpose it 
studied the various methods to be employed, 
procured appliances useful toward that 
end, and bestowed rewards on various 
rescuers. One method of resuscitation which 
the Society especially studied and for some 
years approved, was the use of tobacco 
fumigations in the rectum, special fumiga- 
tors being provided in convenient places 
where drowning accidents were frequent. 
Circulars were drawn up for distribution 
conveying instructions for resuscitation. 
From its origin to the present day, the 
Society has numbered the most prominent 
citizens of Boston among its active members 
and friends. It early began to enlarge its 
scope by the erection of huts of refuge along 
dangerous points on the Massachusetts 
coast wherein shipwrecked mariners would 
find tinder and material for making a fire, 
blankets and food. These huts were the 
first organized effort at establishing any- 
thing like a life saving service on our coast, 
and they proved of the greatest value. 
Stimulated by their success, the Society, 

2 "The Humane Society of the Commonwealth 
of Massachusetts," an historical review, 1785-1916, 
by M. A. De Wolf Howe. Boston, 19 18. 



Historical Notes 



83 



which had launched the first lifeboat 
known in the United States in 1807, in 1840 
began the establishment of life-saving 
stations, equipped with boats and crews 
to man them, at intervals on the coast of the 
State. In 1869 there were no less than 92 of 
these stations in active operation. Two years 
later, in 1871, the United States govern- 
ment instituted its coast guard system, 
thereby obviating to a great extent the 
necessity for private enterprise, so that by 
1 916 the Society had decreased the number 
of its stations to 36. The records of some of 
the heroic rescues, made by its crews, fill 
pages of the book before us, and cause a 
thrill of grateful admiration towards the 
Society which rendered them possible. 
Many and various were the other public 



benefactions of the Society. It offered a 
reward for the best collection of facts bear- 
ing on the origin of yellow fever, hoping 
that if the cause might be ascertained, the 
recurrence of the disease might be averted. 
In 1843 ^ gave $500 towards the purchase of 
a telescope for the astronomical observatory 
at Harvard. It contributed liberally, from 
its funds, towards the establishment of the 
Massachusetts General Hospital and other 
objects connected with the public health. 
It is doubtful if any other organization in 
the United States possesses so long and 
varied a record of useful benevolence, and 
preservation of its history in permanent 
form is well worth while. 

Francis R. Packard 



PASTEUR DRAMATIZED 



The great French pictorial weekly L' Il- 
lustration has recently resumed its practice 
of publishing as a supplement the current 
plays of literary worth produced in the 
theatres of Paris. On March 1st it published 
in this manner "Pasteur," a play in five acts, 
written by Sacha Guitry, and produced 
for its premier at the Vaudeville with the 
author's father, Lucien Guitry, in the title 
role. M. Guitry states that he was stimulated 
to write the play by reading the classic 
life of Pasteur by Valery-Radot. The action 
is based on facts narrated in the book, 
especially the inoculation of Joseph Meister, 
the first patient upon whom Pasteur used 
the antirabic virus. Many of the lines in the 
play are Pasteur's own utterances. The 
final act is the great reception in honor of his 



seventieth birthday. M. Guitry has used 
with dramatic effect some of the vivid 
incidents in the great man's life, and the 
play gives a moving idea of his unswerving 
devotion to scientific truth and of the 
irritation caused him by the unscientific 
criticism of his logical methods and the 
absolute accuracy with which he employed 
them. We know of no similar dramatization 
of a great scientist's achievements, and the 
value of such a production in its effect on 
either professional or lay audiences must be 
immense. Appended are a number of crit- 
icisms by the leading French dramatic 
critics which are unanimous in their expres- 
sions of approbation. 

Francis R. Packard 



BOOK REVIEWS 



Aspects of Death and Correlated Aspects of 
Life in Art, Epigram, and Poetry. Contribu- 
tions towards an Anthology and an Iconography 
of the Subject. Frederick Parkes Weber, M.A., 
M.D., F.R.C.P., F.S.A. XI+786 pages; 145 
illustrations, third edition, revised and much 
enlarged. Price $7.50 net. New York: Paul B. 
Ffoeber. 

The byways of literature are much fre- 
quented by doctors — to their great benefit. 
With a hobby a man is reasonably secure 
against the whips and arrows of the most 
outrageous fortune. Among our English 
brethren an avocation is more common than 
in America, and in the midst of a busy 
practice a man will keep a keen interest in 
literature or botany or archaeology. It is 
interesting to note that at present the Presi- 
dent of the Poetry Society, the President of 
the Bibliographical Society, and of the 
Classical Association, are physicians. 

The volume before us represents the avo- 
cational studies of one of the best known of 
London physicians, and a student of ex- 
traordinary keenness. To-day Dr. Parkes 
Weber is in medicine the successor of 
Jonathan Hutchinson, and an anomalous 
case or a new disease is sure to be illustrated 
at once from his wide experience. This work 
is an outcome of his studies in Numis- 
matics, to which subject he has made many 
valuable contributions, and on which his 
father, the late Sir Hermann Weber, was a 
distinguished authority. 

The book has grown in a remarkable 
way: the first edition, 19 10, consisted of a 
series of articles reprinted with alterations 
and corrections from the Numismatic Chron- 
icle. A second enlarged and revised edition 
appeared in 1914. The present greatly en- 
larged and rearranged edition combines an 



84 



exhaustive iconography of death with a 
complete anthology. It forms, as the author 
says, an "essay on the mental attitudes 
towards ideas of death and immortality," 
and the various ways these have affected 
the individual, as illustrated in epigram, 
poetry, and the minor works of art, such as 
gems, medals, jewels, etc. 

Of the four parts into which the work is 
divided, the first is general and historical, 
the second an arrangement and analysis of 
the various possible aspects of death, the 
third deals with medals and coins, and the 
fourth with engraved gems, rings, and jewels, 
and representations in pottery. It forms an 
extraordinary study on the reaction of man's 
mind towards the last great act; and one is 
astonished at the industry and versatility 
of the author who has laid under contribu- 
tion the literatures of all time. Every aspect 
of death is discussed, and he clothed the 
time-worn skeleton by correlating every 
aspect with the living. 

Of special interest to the doctor is the long 
section in Part 2, dealing with the medical, 
sanitary, and social attitudes towards death. 

It is astonishing how much medical his- 
tory may be read from coins. From the fifth 
century B.C. are Sicilian coins illustrating 
the freeing of Selinus from a pestilence, pos- 
sibly malaria, by the drainage of the neigh- 
boring marshlands. The special work by 
Pfeiffer and Ruland — "Pestilentia in Num- 
mis" — deals with the medals and tokens 
relating to epidemics of plague and other 
infectious diseases. The literary value of the 
work is enhanced by references from the 
authors of every period; for example, under 
this section of the emblematic representa- 
tion of disease, Johnson's striking statement 
is quoted: 



Book Reviews 



85 



It was a principle among the ancients, that 
acute diseases are from Heaven, and chronical 
from ourselves; the dart of death, indeed, falls 
from Heaven, but we poison it from our own 
misconduct: to die is the fate of man; but to die 
with lingering anguish is generally his folly. 

Numerous references are given to the 
extensive lore dealing with the evil eye — 
talismans, amulets, and charms, and to the 
cramp-rings, on which Raymond Crawfurd 
has written so learnedly. In the appositeness 
and fecundity of his quotations Parkes 
Weber reminds one of Robert Burton, and 
nowhere in literature is to be found such a 
collection as that given in this section on the 
satires, sayings, and epigrams relating to 
physicians and their art. He quotes a de- 
licious one which I picked up many years 
ago from the Spectator: 

Wise Arruns, asked "How long will Caius live?" 
Replied, "Three days the fatal sisters give": 
And Arruns knew the prophet's art. But Io! 
Stronger than gods above or gods below, 
Euschemon comes: his healing art he tries, 
And in a single day poor Caius dies. 

The author turns out to be the well-known 
scholar, the Rev. A. J. Church. 

Part 3, dealing with the aspects of death 
in coins, medals, and tokens, is one of the 
longest, and of extraordinary fullness. Il- 
lustrations are given of coins from the fifth 
century B.C. down to the medals struck in 
Germany for the sinking of the Lusitania^ 

To many the book will be a revelation; 
while the learned author disclaims an at- 
tempt to make an exhaustive treatise on the 
iconography of death, or a complete an- 
thology of poetry and epigrams relating to it, 
he has made by far the most important con- 
tribution in English on the subject. The 
author's new preface is preceded by an 
original poem on the mystery of pain and 
death, on which his own views are worth 
quoting. "... The balance of evidence 
(which, however, everyone will and must 
admit, is mainly of a subjective kind) seems 
to me to point to there being something 



more of immortality in human souls than 
can be included under August Weismann's 
theory of the immortality of the germ- 
plasm of animals and plants. Whether or 
not this 'something more' is quite as much 
as a personal 'immortality of souls' is 
a question which should not really affect us. 
One can understand the possibility of a 
kind of reward or punishment, and of con- 
tinued physical activity after the death of 
the body, without being absolutely con- 
vinced of personal immortality." 

As an introduction to the literature of 
subjects with which we have to deal daily, 
the work should go in the bedside library of 
every physician. 

May I end with a personal note? Friends 
have associated my name in a kind way with 
a good many books, but I have never before 
had a dedication which illustrates the 
curiosa jelicitas of the scholar-student. 

William Osler. 

Benjamin Rush and His Services to American 
Education. By Harry G. Good, Ph.D., Pro- 
fessor of Education, Bluffton College. X+219 
pages. Price $1.60 net. Berne, Indiana: Witness 
Press. 1918. 

There have been so many studies of the 
American Sydenham's career and labors 
written from the medical point of view, that 
it is refreshing and timely to find him 
depicted from another standpoint, and 
when the task is performed by so well fitted 
an expert as Professor Good, we may be 
sure it will be well done. Rush is, of course, 
well known as a teacher of medicine, but the 
fact that he wrote often and well on 
educational topics not pertaining to his 
profession, and his instrumentality in the 
foundation of Dickinson College, is not 
familiar to many. In a very complete 
bibliography of his writings appended to 
this book, those on educational subjects 
form a conspicuous part, as do his articles 
advocating the abolition of slavery, pro- 
hibition and penal reform. We of the 



Annals oj Medical History 



profession know with what vigor he was 
wont to enunciate his very pronounced 
views on medical subjects, and he carried 
no less vehemence into his publication on 
other matters. Professor Good bestows 
much praise on the enlightened and advanced 
opinions which Rush held in educational 
matters. Rush showed no less aggressiveness 
and determination when he came to the 
practical application of his ideas in the 
foundation of a college. Good describes how 
it was principally due to his initiative, 
determination, and influence with his con- 
temporaries that Dickinson College came 
into being and was given the impetus which 
in subsequent generations has raised it 
from small beginnings to an excellent rank 
among the smaller colleges of the United 
States. The book only serves to add to 
the great desire of those who are interested 
in Rush, that some day an adequate 
biography of the great man will be written, 
one which will explain the obscure political 
secrets which are interwoven with his 
history as a public man and throw some 
light on his transactions during the critical 
period of the foundation of the United 
States. 

Francis R. Packard 

The History of St. Bartholomew's Hospital. 
By Norman Moore, M.D. 2 vols, quarto. Vol. I, 
pp. xxii + 614, 41 plates. Vol. II, pp. xiv + 
992, 6 plates. London: Pearson, 19 18. 

The very distinguished author of these 
volumes was born in 1847 an d educated at 
St. Catharine's College, Cambridge, of 
which he is an Honorary Fellow. On leaving 
the University he entered as a student of 
St. Bartholomew's Hospital, and has been 
closely connected with that institution for 
nearly half a century. In 1883 he was 
elected Assistant Physician, in 1902 Phy- 
sician and in 191 1 Consulting Physician. In 
1 91 8 Dr. Moore became President of the 
Royal College of Physicians of London, a 
foundation with which his connection has 



been as close and as long as with St. 
Bartholomew's Hospital. Dr. Moore has 
been recognized for many years not only 
as an eminent physician, but as a most 
learned medical historian of high scholarship 
and literary attainments and especially 
equipped for mediaeval studies. Personally 
he has earned the respect and affection of 
generations of students and younger work- 
ers, not only by his learning and clinical 
skill, but by geniality of character and an 
unrivaled power as a raconteur. This truly 
monumental work by Dr. Moore undoubt- 
edly marks an epoch in the history of 
medicine. The preparation has been a 
labor of love of thirty years' duration and 
it is now presented by its author to the 
Hospital where so much of his life has been 
spent. It is a gift in which any institution 
might well glory. 

In attempting to deal with a document of 
this order the reviewer is in a serious 
difficulty; to summarize it is impossible, 
to criticise it seems impertinent, to praise 
it would be superfluous. He will, therefore, 
not attempt any of these, but will devote 
himself rather to some attempt to place the 
work in what appears to him its rightful 
position in the literature of Medical History. 

So far as English writing is concerned 
the earliest important medico-historical 
author was certainly John Freind (1675- 
1728). His work "The History of Physick 
from the time of Galen to the beginning 
of the XVIth century chiefly with regard 
to Practice," was drafted while in prison 
(1722) under a charge of complicity in a 
Jacobite plot, and first printed in 1725. It is 
not entirely original, but is of value and 
interest and may be read with profit even at 
the present day, and is especially remark- 
able for its date in the attempt it makes to 
trace the continuity of ideas from age to 
age. In his own century Freind was followed 
by several of his countrymen; by Richard 
Mead (1 672-1 754), eminent alike as biblio- 
phile physician and patron of learning, who 



Book Reviews 



87 



contributed the "Diseases Mentioned in 
Sacred Writings" (1749), as well as a work 
on the physicians of ancient Rome (1724), 
and on whose advice, stimulus and expense, 
certain Arabic medical works were rendered 
into English; by Edward Milward (?-i757), 
who wrote an "Account of Alexander 
Trallian" (1734); and by James Greive 
(7-1778), who published in 1756 an anno- 
tated translation of Celsus that remains the 
best in our language. The only other medico- 
historical document of any importance that 
appeared in England in the 18th century is 
the "History of the Origin of Medicine" 
(1776) of John Coakley Lettsom (1744- 
18 15), a man of remarkable attainments 
who exhibited some of the newer influences 
of which we shall presently speak. 

In the meantime the prevailing biograph- 
ical note of British medical scholarship 
had long asserted itself. As early as the 17th 
century Baldwin Harney, the younger 
(1600-1676), prepared a series of sketches of 
his contemporaries, which remain in manu- 
script but have been much used by later 
writers. In 17 15 appeared also what was 
probably the first systematic medical bib- 
liography, the "Bibliographic Anatomica? 
Specimen" by the distinguished anatomist, 
James Douglas (1 675-1 742). This important 
contribution undoubtedly formed the basis 
of the well-known work on the same subject 
by his friend Albrecht Haller. Numerous 
other attempts at medical biography and 
bibliography were made, but among them we 
need only refer to Edward Milward (?-i757), 
who published his "Letter to all Orders of 
Learned Men concerning a History of the 
Lives of British Physical and Chirurgical 
Authors" in 1704, and the "Biographical 
Memoirs of Medicine in Great Britain from 
the Revival of Literature to the time of 
Harvey," by John Aikin (1 747-1 822) which 
appeared in 1780 and contained accounts of 
fifty-five authors from the time of Gilbertus 
Anglicus to that of Glisson. From Aikin 
onward biography has been the strength 



and weakness of English medico-historical 
work, the most important contributions in 
this department having been made by 
William Munk in his "Roll of the Royal 
College of Physicians of London" (1st 
edition 1861; 2d edition 1878), Benjamin 
Ward Richardson in his "Disciples of 
^Esculapius" (1900) and Dr. Norman Moore 
himself, who has contributed a host of 
admirable medical biographies to the "Dic- 
tionary of National Biography" (1885- 
191 2). In this prevalent biographical tone 
English, and, it may be added, American 
medical scholarship, have been somewhat 
isolated from the main current of Historical 
Research to which we may now return. 

The year 1776 is a landmark in the history 
of scholarship, for there then appeared a 
volume which was not only an extraordinary 
feat of learning, but a work of the highest and 
most original genius. In that year Edward 
Gibbon ( 1 737-1 794), now in his fortieth 
year, published the first volume of the great- 
est of all historical writings. During the 
twelve years preceding 1788, when the last 
volumes of "The Decline and Fall of the 
Roman Empire" saw the light, a revolution 
in historical thought and historical method 
had been effected comparable only to that 
of the general acceptance of evolutionary 
doctrine in the following century, to which 
movement indeed it is related. It is not too 
much to say that Gibbon's was the first 
great evolutionary historical work, that 
evolutionary teaching is implicit in the 
"Decline and Fall"; and that the evolution- 
ary school of historians was a necessary 
preliminary to the evolutionary school of 
biologists. From Gibbon's date onward all 
historical work of permanent interest and 
value became instinct with his spirit; from 
his time onward the main duty of the 
historian has been the demonstration of 
continuity, the process by which the phe- 
nomena of each age are derived from the 
preceding age and pass into that which 
follows, and the secular interaction of forces 



Annals of Medical History 



has riveted the attention of the ablest 
historical writers. As the years have gone 
by and as history has come more and more 
into line with biological teaching, a yet 
further phase has appeared or rather has 
logically developed from Gibbon's method. 
No longer content with relations of the 
deeds of kings and conquerors, nor even of 
statesmen and religious leaders, we seek to 
know how these men came to be what they 
were, and we look to our historians to tell 
us of the origin and development of our 
economic and social systems. Their search is 
thus less often among the annals and 
treaties of states, and more often in mer- 
chants' accounts and folk tales. Even the 
grandiose monuments and records of con- 
quering things are no longer taken literally, 
but by means of ethnological researches and 
archaeological exploration we read between 
the lines of their statements and often 
enough find them little else than lies. Men, 
we know, may be largely explained as the 
result of their inheritance and environment, 
and since the most interesting and important 
part of Man is the thoughts and ideas of 
which he is the carrier, we are beginning to 
write the history of thought with reference 
to the inheritance and environment of those 
ideas and thoughts. With this newer and 
nobler view of history in our minds let us 
turn to the achievements of English speak- 
ing peoples in the history of our special 
subject. 

The striking feature of Freind's work, and 
of Leclerc's, who preceded him, is that they 
seem prophetically though dimly to have 
perceived the attitude of the later his- 
torians, and to have devoted themselves to 
some extent to the demonstration of con- 
tinuity. It is not, however, until we get to 
the very end of the 18th century, that we 
encounter a true medical historian of the 
first rank in the person of Kurt Polykarp 
Sprengel (i 766-1 833), whose "Pragmatic 
History of Medicine," published at Halle 
between 1792 and i8i3,is not only a monu- 



ment of historical method, but a mine of 
information that is hardly yet worked out. 
Sprengel exhibits to the full the influence 
of the new school. On the continent other 
works of similar character rapidly followed 
on Sprengel's, but in spite of the example 
of our great historian of science, William 
Whewell (1794- 1866), England had long to 
wait for a work of medical scholarship 
that did not suffer from the biographical 
obsession. This perhaps was owing to the 
suspicion in this country of the work of 
Auguste Comte (1798- 185 7), who more than 
any other man opposed the static aspect of 
history and, foreseeing its biological mean- 
ing, summed up his view in the aphorism 
that "an idea cannot be understood until its 
history is known." His phrase would provide 
an admirable text for a history of medicine. 

In 1844 there appeared from the pen of 
Francis Adams of Banchory (1 796-1 861) 
the first work of scholarship of the front 
rank that had been produced by an English 
medical writer. But his "Seven Books of 
Paulus iEgineta" (1844) is more than a 
work of scholarship, it is a true historical 
work "embracing" as its sub-title, not 
unjustly, claims, "a complete view of the 
knowledge possessed by the Greeks, Romans, 
and Arabians on all subjects connected with 
medicine and surgery." This is still a 
standard work and remains by far the best 
in English on the medicine of classical 
antiquity. In spite of the high standard of 
the other works of Adams the "Extant 
Works of Aretaeus the Cappadocian" (1846) 
and the "Genuine Works of Hippocrates" 
(1849), his "Paulus ^Egineta" must be con- 
sidered his masterpiece. It contains much 
real history well arranged and indexed and 
is especially valuable as one of the few works 
of medical scholarship in which the clinical 
experience of the author definitely asserts 
itself. 

The "Origin of Species" had already seen 
the light for five years before the most 
important piece of medical scholarship that 



Book Reviews 



89 



has yet appeared in English was issued 
from the press. This work is most curiously 
not by a medical man, but by a clergyman 
of the Church of England. The "Leechdoms 
Wortcunning and Starcraft of Early 
England" (1 864-1 866) of the Rev. Oswald 
Cockayne (1 807-1 873) conceals under a 
maddening combination of misarrangement, 
perverse conservatism, vicious English, and 
hideous typography, a mass of learning, 
patient labor, and scientific method that 
places it, as it appears to the present writer, 
without rival as the most important and 
fundamental work of medical scholarship of 
any English writer. The basis of the work 
had been prepared in the previous hundred 
years by the recovery of the Anglo-Saxon 
language from the manuscripts by the 
labor of such men as Hickes, Kemble, 
Thorpe, Wright, and Bosworth, but to the 
edifice that they had constructed Cockayne 
made definite and permanent additions and 
his work will always be treated with respect, 
not only by medical historians, but by all 
concerned with the origins of the English 
language. On account of its linguistic and 
philological value, of the originality of its 
conception, of the thoroughness of its 
scholarship, of its interest as our source book 
of Western barbarian medicine, and in 
spite of its absence of literary form and 
repellent presentation, we are convinced 
that posterity will regard the work of 
Cockayne as the most important original 
English contribution to the History of 
Medicine. Cockayne's work is especially 
important since the Anglo-Saxon Leechdoms 
contain the only considerable remnants of a 
barbarian medical system that have survived 
to our day from the period of the decline 
of the Roman Empire. These remains, 
properly sifted, can be made to yield a fairly 
accurate and adequate idea of the medicine 
and science of the Teutonic tribes of 
northern Europe. 

After Cockayne the second place, as it 
appears to us, may be disputed between 



the work of Dr. Norman Moore which lies 
before us, and the "Paulus yEgineta" of 
Francis Adams. In all these three works 
of the front rank we are inclined to think 
that posterity will observe with regret a 
relative absence of regard for the results of 
continental scholarship, a respect in which 
they are excelled by several living medical 
scholars, and by at least one who is no 
longer with us. The late J. F. Payne (1840- 
1910) was a man of wide learning and general 
culture, who possessed a fine literary sense 
and was fully acquainted with the revolu- 
tion that the studies of the mediaeval school 
of continental historians had accomplished 
in the history of medicine. Payne was 
especially familiar with the great triumph 
of that school in the recovery of the Saler- 
nitan literature, and the use of this knowl- 
edge by him gives his reinvestigation of 
Cockayne's work a distinct historical value. 
But on the whole we may say that this 
writer's extreme diffidence and exaggerated 
caution prevented his actual historical 
performances from approaching within 
measurable distance of his great powers 
and reputation, and his work must rank 
definitely below that of Cockayne, Adams, or 
Dr. Moore. 

Turning again to the volumes of Dr. 
Moore that lie before us, we find the entire 
first and one-third of the second occupied 
with a detailed description of the charters 
and other material that have survived 
concerning the St. Bartholomew's Hospital 
from 1 123-1537. This collection is by far 
the fullest and most complete that has been 
attempted for any such institution. It is 
unlikely that any future worker will find 
even gleanings in a field where the learning 
and industry of Dr. Moore have garnered 
so long and so faithfully, and this work will 
remain permanently as a source book and a 
type of what such a history should be. 
The large number of illustrations, consisting 
as they do almost exclusively of beautiful 
reproductions of charters, will, in addition, 



90 



Annals of Medical History 



render it welcome to the student of palaeog- 
raphy. When we come to the later period 
the work is no less valuable, but in a some- 
what narrower field. The science and 
medicine of the 17th, 18th, and 19th cen- 
turies emanated from a larger number of 
centers and were less uniform in character 
as well as far greater in literary output 
than in the centuries that preceded. For 
this later period Dr. Moore's work will be 
valued as probably the best extant account 
of a single institution, and the future medical 
historian will seek to incorporate its material 
in a picture of the general stream of medical 
thought. The tendency, however, of political 
history to deal with ethnic movements and 
economic forces must ultimately assert 
itself also in the history of medicine, where 
it will be represented by streams of ideas 
and thoughts rather than accounts of per- 



sonalities. When that time shall come the. 
biographical work of Dr. Moore may per- 
haps be less read by the general reader, but 
it will not cease to be regarded by the 
historical specialist, who will study him for 
the accuracy and fullness of the records 
that he has handed down. 

A very touching and pleasing feature of 
the work is the manifest affection of its 
author for his Hospital, and especially for 
its suffering inmates, and these volumes 
will keep his memory green so long as men 
who speak the English tongue love old 
things and good writing and simple acts of 
mercy. As we close the cover we join Dr. 
Moore in the time -honored toast with 
which he terminates this great book: 
"Prosperity to St. Bartholomew's Hospital 
and Health and Ease to the Poor Patients." 
Charles Singer 



CORRESPONDENCE 



THE STERILITY OF CATHERINE DE MEDICI. 



A correspondent having heard the fre- 
quently made statement that the sterility 
of Henri II's Queen, with her subsequent 
remarkable fecundity, was due to a mal- 
formation of the King's urethra which was 
corrected by operation, writes for further 
information on this much discussed topic. 
A valuable recent contribution to the sub- 
ject is that of Dr. Cabanes, 1 which gives all 
the known facts in the case with full refer- 
ences to the chief authorities for the various 
versions of the stories anent the subject. 
These may be summarized as follows: 
Catherine de Medici was born at Florence 
in 15 19 and was married to Henri II in 
1532, when not quite fourteen years old. 
Henri was but a few months her senior. 
Her father, Laurent de Medici, as well as 
her mother, having died in her infancy, her 
marriage had been arranged by her uncle, 
Pope Clement VII, and he was so anxious 
to have some proof of the consummation of 
the marriage of these two children that he 
remained at Marseilles thirty-four days 
after the ceremony hoping that such proof 
might be apparent before he left the newly 
married pair, and when nothing transpired, 
he made his famous remark to Catherine, 
"Posterity never lacks to a girl of spirit." 
For ten years the Queen was childless, to 
the great unhappiness not only of herself 
and her husband, then the Dauphin, but 
also of her father-in-law Francois I, and 
the French people. The question of a 
divorce was agitated and according to Miss 
Sichel, Diane de Poitiers, the King's mis- 
tress, had almost convinced Francois that 

1 "Le Cabinet Secret de PHistoire," Article "La 
Sterilite de Catherine de Medicis." 



Catherine should be repudiated and a wife 
capable of bearing children provided for Henri 
in her stead, when Catherine quite unex- 
pectedly became pregnant, and on January 
19, 1543, gave birth to the future Francois 
II. This happy event was followed by the 
birth of nine other children, the last 
accouchement being with twins on July 
24, 1556. Thus Catherine had her first child 
when she was twenty-four years old and her 
last when she was thirty-seven. During the 
long period of her sterility she had recourse 
not only to physicians, but quacks, magicians, 
and astrologers in her efforts to secure advice 
which would enable her to become pregnant. 
It is known that Henri's father, Francois 
I, and Catherine's father, Laurent de 
Medici, both had syphilis, but there is 
positive evidence that neither of them 
manifested the disease before the births of 
their respective children. Henri and Cath- 
erine were both physically well and strong, 
Henri's greatest passion being for tourna- 
ments and hunting, the latter being also a 
favorite amusement of his wife's, so much 
so that on several occasions she suffered 
severe injuries from falls from her horse. 
There are many contemporary expressions 
of admiration at the health enjoyed by 
the royal couple. Contrary to the general 
trend of stories told on the subject, the 
sterility was not due to impotence on 
Henri's part, as he had in 1538, long before 
the birth of his first child, an illegitimate 
daughter by a Piedmontese girl, who was 
brought up at court and known as Diane 
de France. He also had various liaisons, 
especially that with his father's mistress, 
Diane de Poitiers, whom he loved with the 



91 



92 



Annals oj Medical History 



deepest affection, although she was some 
seventeen years older than he; and though for 
that reason some have thought their friend- 
ship purely platonic, there is proof in their 
correspondence that it was far otherwise. 

As to Fernel's share in the change of 
Catherine's lot, Cabanes points out that 
Plancy, his historian and disciple, makes 
no mention of the matter in any way, 
whereas as Plancy was twenty-nine years 
old when Francois II was born he must 
have heard about the circumstances and 
had no reason to conceal any fact that 
would so much redound to his master's 
credit. Likewise neither Brantome nor 
L'Estoile, who certainly were en rapport 
in all court gossip, make any reference to 
Fernel in their writings, which are so full of 
details of all court doings, and especially 
of spicy ones. In fact L'Estoile states that 
Catherine's first pregnancy had resulted 
from the aid given her by a "woman." 
De Thou and Scaliger who wrote towards 
the close of the 16th century do not 
either of them give any clue in the matter. 

The first mention of Fernel's intervention 
occurs in Louis d'Orleans' book, "Plante 
Humaine," and is given by Cabanes: 

"Henri II not being able to have children 
consulted many skillful physicians of the 
Faculty of Medicine of Paris, who refused 
to help him. Someone suggested Fernel 
to him, and he laughingly demanded of 
him in the presence of the Queen if he could 
cause her to have children. Fernel replied 
that it belonged to God to give them, to 
her Majesty to make them, and to him to 
teach her the precepts of the art, by which 
she could arrive at it. Some time afterward 
the Queen became pregnant, and on perceiv- 
ing it sent him ten thousand ecus, and when 
couched as much again with a buffet of sil- 
ver, and this she did at each accouchement." 

Gabriel Naude, the famous librarian of 
Cardinal Mazarin, in the course of an ad- 
dress at a seance of the Faculty of Medicine 
of Paris in 1628, repeated this story of 



d'Orleans' with the modification that it 
was the King and not the Queen who so 
liberally rewarded Fernel. 

Cabanes next quotes the historians 
Mezeray and Varillas as stating that Fer- 
nel's counsels consisted in advising the 
King to have intercourse with the Queen 
during her menstrual period, and quotes 
their statements that the ill-health of their 
offspring was attributable to conception 
having occurred at this time. The theory that 
conception was most apt to follow inter- 
course at a. menstrual period and that the fruit 
of such conception was liable to be unhealthy 
was very common among the Ancients. 

The famous surgeon Dionis in his "Traicte 
sur Ies Accouchements," published in 171 8, 
states that Fernel, after a study of the 
relations of the King and Queen, counseled 
a particular posture to be used by the 
King during intercourse. 

Cabanes quotes in a footnote a passage 
from Balzac's "Etudes philosophiques sur 
Catherine de Medicis" the statement made 
by Balzac, referring to Bayle as his author- 
ity, that Fernel operated on Henri II, and 
I believe that this is the source from which 
most readers have drawn their mistaken 
ideas in the case. After reviewing the 
above statements it would seem very 
probable that Fernel had nothing to do 
with it beyond his attention at the Queen's 
accouchements, and it is certainly very 
doubtful if any operation at all was per- 
formed on the King. Operations on royalty 
for many years subsequent to Henri's time 
were matters of common talk, no matter 
how indelicate the nature, witness the 
operation on Louis XIV for fistula in ano, 
which even led to nobles of the court being 
operated on or pretending to be, for the 
same disorder. As the story originated 
when Henri had been dead for half a century 
and is unsupported by any contemporary 
testimony it may, as Cabanes states, be 
regarded as utterly without foundation. 
Francis R. Packard. 



VOLUME 




NUMBER 2 



ANNALS OF 

MEDICAL HISTORY 



"c 







y^SSS^m!^. 






(MAR 17 1920 






^JoaalMuJ^ 


m SP ■ ■ wwti^ 




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£ 



FRANCIS R'PACKARD'M'D'EDITOR [PHILADELPHIA] 
PUBLISHED QUARTERLY BY PAUL < B ' HOEBER 
67-69 EAST FIFTY-NINTH STREET' NEW YORK CITY 



Entered as second class matter June 2, 1017, at the post office at New York, N. Y., under the Act of March 3, 1879. 
Yearly Subscription $8.00. Single numbers $2.50. 



CONTENTS OF VOLUME I 

NUMBER ONE 

The Scientific Position of Girolamo Fracastoro 1478? — 1553 
with Especial Reference to the Source, Character and 
Influence of His Theory of Infection . . Charles 

The Greek Cult of the Dead and the Chthonian Deities in 
Ancient Medicine 

The Three Characters of a Physician 

Voltaire's Relation to Medicine 

An Unpublished Bronze Ecorche . 

Burke and Hare and the Psychology of Murder 

Hebrew Prayers for the Sick . 

Laryngology and Otology in Colonial Times . 



and Dorothea Singer 

Fielding H. Garrison 

Enricus Cordus 

. Pearce Bailey 

Edward Streeter 

Charles W. Burr 

C D. Spivak 

Stanton A. Friedberg 



NUMBER TWO 



Eulogy of Dr. John Shaw Billings ... 

The Hygienic Idea and Its Manifestations in World History 

A Patronal Festival for Thomas Willis (i62i'i675) with Re 
marks by Sir William Osier, Bart., f.r.s. . 

Medicine and Mathematics in the Sixteenth Century 

Historical Development of our Knowledge of the Circulation 
and Its Disorders 

The Jetons of the Old Paris Academy of Medicine in the 
Numismatic Collection in the Army Medical Museum 
at Washington 

The History of Infection 

Text of William Shippen's First Draft of a Plan for the Organ- 
ization of the Military Hospital During the Revolution . 

The Beginnings of Intravenous Medication . . Horace 

The Legislative and Administrative History of the Medical 
Department of the United States Army During the Rev- 
olutionary Period (i776'i786) 



Abraham Jacobi 
. Karl Sudhoff 

Henry Viets 
David Eugene Smith 

Philip S. Roy 



Albert Alleman 
Arnold C. Klebs 



Manchester Brown 



William O. Owen 



NUMBER THREE 

Figurations of Skeletal and Visceral Anatomy in the Books 

of Hours . . . Wilfrid M. de Voynich and Fielding H. Garrison 

Babylonian' Assyrian Medicine Morris Jastrow, Jr. 

On a Greek Charm Used in England in the Twelfth Century . . Charles Singer 
Military Sanitation in the 16th, 17th and 18th Centuries Charles L. Heizmann 

A Check List of Medical Incunabula in the Surgeon'General's Library 

NUMBER FOUR 

The First Printed Documents Relating to Modern Surgical 

Anaesthesia 

Byzantine Medical Fragments . ... 

The New York Medical College 1782-1906 .... 

Studies in Paleopathology. I. Consideration of Evidences of 

Pathological Conditions Found Among Fossil Animals . 
Plague Tractates .... Dorothea Waley Singer and Reuben Levy 
The Medical Phrases of Victor Hugo .... Hubert Ashley Royster 



. William Osler 
. Charles Singer 
Abraham Jacobi 

. Roy L. Moodie 




6tA-uAs*>. J^v^r? 



ANNALS OF MEDICAL HISTORY 




Volume ii 



Summer 1919 



Number 2 



A HOUSE-SURGEON'S MEMORIES OF JOSEPH LISTER 1 

(Born April 5, 1827. Died February 10, 191 2) 
By SIR ST CLAIR THOMSON, M.D. 

LONDON, ENGLAND 




S WE ALL know, 
Robert Browning lived 
a great part of his life in 
Italy and died there. 
Many years before his 
death another of our 
greatest poets, Percy 
Bysshe Shelley, was 
drowned off the coast of Leghorn and 
lies buried in the Cimitero degli Allori, just 
inside the walls of ancient Rome. This 
was some time before Browning settled in 
Florence; thus it came to pass that when, 
once in Italy, Browning made a friend who 
had known Shelley personally he was so 
overcome by the thought that he was look- 
ing into the eyes of one who had actually 
gazed on Shelley, in his very habit as he 
lived, that he wrote of it in these lines : 

"And, did you once see Shelley plain, 
And did he stop and speak to you, 

And did you speak to him again? 
How strange it seems and newl" 

It has struck me that before the genera- 
1 An address delivered in the College of 



tion to which I belong passes away, it is a 
duty, as it is a very grateful task, for those 
who once saw Lister plain, to put on record 
some of our personal recollections and 
impressions of that great man; great, not 
only in that his name as a scientific sur- 
geon and a benefactor of humanity will live 
forevermore, but in that he exerted on 
those who came into personal contact with 
him an influence, a devotion, and an ele- 
vation of thought and soul that had in it 
a touch of inspiration. In commenting on a 
paper of mine on "Shakespeare and Medi- 
cine," that well-known authority on Shakes- 
peare, Sir Sidney Lee, said that Shakes- 
peare, after God, had created most in the 
cosmic universe. I venture to say that, as 
an instrument in God's hands, Lister has 
wrought more for the relief of suffering, for 
the security of life, for the prevention of 
anxiety, and for the promotion of happiness 
than any one man who has ever trod 
this earth. And, in addition, those who 
chanced to come near him caught glimpses 

Physicians, Philadelphia, on June 14, 1919. 

93 



94 



Annals of Medical History 



of a spirit such as is seldom revealed 
to us. 

On Monday, October i, 1877, I entered 
as a student at King's College, London, 
attracted there entirely by the great name 
of Lister, to whom my attention had been 
directed by a brother who had been his 




Lord Lister, aged 69. 

pupil in Glasgow. On that same first day of 
October, 1877, Lister, coming from Edin- 
burgh, entered on his duties as professor of 
clinical surgery in King's College Hospital. 
Educated at University College and a 
graduate of London University, Lister had 
already achieved what some would think 
the success of a lifetime, in that, though an 
Englishman by birth, he had migrated to 
Scotland and had there successively filled 
the chair of surgery in the two great 
universities of the north, — in Glasgow from 
i860 to 1869, and in Edinburgh from 1869 
to 1877. He had been working all that time 
at the process of healing in wounds and the 
best methods of promoting it. The so-called 



"antiseptic system" had been evolved in 
Glasgow and developed in Edinburgh. I 
say advisedly "so-called system" for almost 
through his whole life Lister had to fight 
hard in defence of the principles on which 
he based his methods of wound treatment; 
the methods employed were, of course, 
subject to constant revision, alteration and 
improvement, and so could not sclerose 
into "a system," though the principles 
remain fixed. But the unthinking crowd, 
even in a learned profession like ours, shies 
at principles and always wants to pin the 
wings of thought down upon the cardboard 
of what the Englishman likes to call "prac- 
tical methods." Hence Lister's treatment 
of wounds was frequently called the "car- 
bolic method," or "the gauze and spray 
system." He once said to me that he ex- 
pected to spend his life searching for an 
antiseptic that was non-irritating. In these 
efforts, he moved from carbolic lotion to 
boracic, or made trial of corrosive subli- 
mate, and then reverted to carbolic. Or he 
saturated his gauze with carbolic iodoform, 
eucalyptus or double cyanide of mercury. 
These seekings after truth were all causes 
for stumbling to the average individual, 
who loves finality and a ritual he can 
adopt — no matter if he does so unthink- 
ingly — so long as he can carry on with it 
indefinitely. This appreciation of general 
principles, so natural to the logical Latin 
mind of France and Italy, is strikingly 
wanting in the national character of Eng- 
land. As Matthew Arnold says, we have no 




Upton House, in the County of Essex. Birthplace of Joseph 
Lister, April $, 1827. 



A House-Surgeon's Memories of Joseph Lister 



95 



sense of the idea. This is strange when we 
recollect that some of the greatest abstract 
thinkers have belonged to the British 
Isles — Hume, Hamilton, Locke, John Stuart 
Mill, Bain, Adam Smith, Herbert Spencer. 
But, on scrutinizing these names more 
closely, we cannot help noting that the 
majority of them indicate that their owners 
came from north of the Tweed. Certainly in 
Scotland, Lister had a far larger and more 
devoted following of pupils than he ever 
gained in London. In Edinburgh the num- 
ber of students who crowded the theatre to 
attend his regular course of clinical surgery 
frequently exceeded 400; and foreign sur- 
geons from all the countries of America 
and Europe, and even the outmost dwellers 
of Mesopotamia, had been flocking for 
years to Glasgow and Edinburgh. A few, 
a very, very few young surgeons from Lon- 
don had ventured north to see and hear 
about this new antiseptic method of treat- 




ing wounds, the two most notable being his 
own nephews — Marcus Beck, afterwards 
on the staff of University College Hospital, 
and Rickman Godlee, later on president 
of the Royal College of Surgeons and the 
author of that biography of his uncle which 
every physician should read. 




Listek, aged thirteen years. A silhouette by his father. 



Joseph Lister, aged about 28. 

What induced Lister to leave the high 
position he had in Edinburgh, his wards of 
sixty to seventy beds in the Royal Infirma- 
ry, and these crowded classes of attentive 
students, to come to a small school in Lon- 
don where only twenty-four beds were 
allotted to him and where the students of 
all four years (the curriculum was then a 
four-year one) together only amounted to 
142? In Edinburgh the average annual 
entry of medical students was over 180; 
in King's College it was less than 25. 
In London, instead of the University spirit 
of the northern capital, he was sure to be 
met with the insularity and parochialism 
which is perhaps more marked in London 



9 6 



Annals oj Medical History 



than in any other spot in the United King- 
dom. His coming was not in order to have 
a larger field for private practice. Always 
blessed with a sufficiency of private means, 
Lister at no time courted the pecuniary re- 
wards of practice, and he died a compara- 




Professor James Syme. 

tively poor man. It was not to hunt for hon- 
ors or distinctions; Lister, brought up a 
Quaker, thought little of such adornments. 
All who knew him are convinced that he 
accepted the invitation to come south 
simply and solely because he felt that on the 
larger and more central stage of the metrop- 
olis he could so demonstrate his work that he 
would the sooner fulfil his mission and win 
the whole world to accept his principles. 
In taking leave of his class in Edinburgh he 
expressed the pleasure that, under the risk 
of having his motives in leaving Edinburgh 
for London quite misunderstood, so large 



a number of Edinburgh students did really 
believe what was the truth — that it was 
only a sense of duty which had made him 
come to the decision to leave that school. 
He added that it was a wrench to leave a 
school in which he had received great 
kindness, and to take a cold plunge into 
what might prove to be a sea of troubles. 2 

He was indeed right; a cold and stormy 
sea of trouble was awaiting him. Lister 
returned from professorships in the Scottish 
Universities to his own southern people, to 
the city of his birth and the country of his 
own form of faith. He returned to his own 
and his own received him not. 

On Monday, October i, 1877, as already 
recorded, I entered King's College, London, 
as a student and Joseph Lister entered it as 
a professor. But, in addition, on that day 
he also delivered the introductory address 
of the session 1 877-1 878. These inaugural 
orations have nearly died out; at that time 
they were almost universal. As a rule they 
were devoted to pointing out to freshmen 
the nobility, responsibilities and privileges 
of the profession to which they were about 
to devote themselves, and urging them by 
hard work, simple living and high thinking 
to make themselves worthy of it. They 
were, as a rule, friendly functions; the usual 
oration did not make too much demand on 

2 Brit. M. J., 1877, vol. ii, Aug. 4, p. 145. 




Glasgow Infirmary, where Lister held the chair of surgery 
from i860 to 1869. 






A House-Surgeon's Memories of Joseph Lister 



97 



our thinking capacity, and we all came 
away cheered, as we always are, by a call 
to high endeavor, to "make our reach 
exceed our arm, else what's Heaven for?" 
As a rule they were limited to the past and 
present students of each school. 

But Lister, to most people's astonish- 
ment, opened his address by stating that 
he was going to record some experiments 
he had made (during his holidays, forsooth!) 
"to obtain some positive and definite 
knowledge of the essential nature of a class 
of phenomena which interest alike the 
physician, the surgeon and the accoucheur, 
viz., the changes in organic substance 
which are designated by the general term 
fermentation." 3 This address was delivered 
from behind a table, covered with pipettes, 
test tube stands, glass flasks, tubes con- 
taining milk and blood, and the other 
paraphernalia required to demonstrate Lis- 
ter's contention that neither milk nor 
blood had any inherent tendency to putre- 
faction, and that if either of these fluids 
was drawn and preserved under what we 
should nowadays call "sterile conditions," 
it remained free from putrefaction in- 
definitely. This is all accepted doctrine 
nowadays, as "most can raise the flowers 
now, For all have got the seed" (Tennyson). 
But although it was not so forty-one years 
ago, I need not deal further withthe lecture, 
which can be read in full in the^British 

3 "Brit. M. J., 1877, vol. ii, Oct. 6, p. 465. 




Medical Journal of that year. What I 
would like to recall is that, although the 
large theatre in the College was crowded 
from floor to ceiling, and although Lister 
had a warm reception from former pupils 
and distinguished men of science, and 




Edinburgh Infirmary, where Lister lectured from 16 
to 1877. 



Joseph Lister, as he appeared when about 40 years old. 

although many surgeons had, on this open- 
ing day of the session, left their own schools 
to come and hear him, yet it was generally 
thought that such an abstruse subject as 
lactic acid fermentation had no concern 
for a professor of surgery, that he did not 
seem the sort of teacher to show a student 
how to get through his examinations, that 
this man fiddling about with flasks and 
test tubes and talking about "putrefactive 
fermentation" could not be the "practical 
man" so dearly beloved in that Victorian 
generation, which could not possibly have 
imagined that a medical man like Clemen- 
ceau could write novels and at seventy-five 



98 



Annals of Medical History 



years of age be the leader of a great nation 
like France, or that a soldier like Foch 
might write books on Avar and be a lecturer 
in a military academy, and yet lead to vic- 
tory the greatest army the world had ever 
seen, or that a college professor like Wood- 
row Wilson would be elected as their Presi- 
dent by a nation of one hundred millions 
of practical people. 

I sadly confess that at Lister's opening 
address we students were bored, and we 
showed it. Forty-one years ago it was not 
thought to be discourteous or "bad form" 
to disturb or even kick up a row at a 
lecture. Consequently we shuffled our feet 
and reminded the lecturer sotto-voce that 
his hour was up and that it was tea time! 
When he was describing his investigations 
on the fermentation of milk he had occasion 
to refer to the cow-house and to cows — and 
then we boo-ed, and if he mentioned the 
dairy-maid we said "tut, tut," and thought 
ourselves very funny fellows! 

This first plunge at the College was cer- 
tainly chilly, but it was at the hospital 
that Lister encountered his full sea of 
troubles. He had stipulated that he should 
be allowed to bring with him from Edin- 
burgh four assistants already trained in his 
methods and attached solely to his service. 
This was a cause of offence; first, because 
it was held that any dresser could employ 
carbolic lotion and gauze, just as previously 
he had learned to apply water-dressing or 
oakum; and second, because in those days 
operations were so uncommon that a single 
house-surgeon and one theatre had pre- 
viously sufficed for all the three senior 
surgeons of the staff. The house-surgeon 
whom he brought with him came from the 
Shetland Isles, and his name will not be 
unknown to you as Sir Watson Cheyne, 
who later succeeded his master as professor 
in King's College Hospital, served as presi- 
dent of the Royal College of Surgeons, and 
now, retired from practice, is an active 
Member of Parliament. The senior dresser 



came from this side of the Atlantic. Dr. 
John Stewart of Halifax, Nova Scotia, was 
one of the most affectionate pupils of the 
master, whom he has drawn in many telling 
pen pictures. From 1878, when I had last 
seen him acting as a dresser in London, 
forty years passed before we met again. 
Then I found him a year ago following the 
flag in France, and serving in his seventieth 
year as Commandant of a Canadian hos- 
pital in Havre. 




The Old King's College Hospital, London, where Lister 

worked from 1877 till 1893. The building has now been 

pulled down. 



Vexatious opposition to Lister and his 
energetic though humane work came chiefly 
from the nurses. In those days the Hospital 
did not control its own nurses; the nursing 
was, so to speak, leased out to a body which 
was much more a religious sisterhood than 
a nursing staff, composed of the Sisters of 
St. John, an Anglican community, much 
given to ritual repression, frigid rules, the 
exaltation of what was considered the reli- 
gious care of the patient above his medical 
well-being, and withal, with a mailed fist 
ever clenched and ready for any helpless stu- 
dent, resident, or even member of the staff 
who showed any tendency to lese-majeste. 
I could many a tale unfold of these far-off 
days and battles long ago between the 
nursing and the medical staffs. I only men- 



A Hoi/SE-SuRGEOx's MEMORIES OF JOSEPH LlSTER 



99 



tion them because lister suffered more tfi.au 
any otfier uieuxber of tfie staff from their 
petty restrictions, tfieir frigid rules, and 
their repressive formality. Tfiey made them- 
selves particularly obnoxious to Lister, as 
fie gave more work tfian any otfier surgeon; 
fie visited fiis wards daily, instead of twice 
a week; fie fiad tfie boldness to sfiow firm self 
at tfie Hospital after dinner, or even on a 
Sunday if a case gave firm any anxiety; also 
tfie tecfinique of his dressings involved 
mucfi wasfiing-up and tfie spreading of 
mackintosfi.es to Ifmft tfie effects of tfie 
clouds of watery carbolic spray in wfiicfi we 
tfien worked. At least two fiours daily were 
taken up by dressings, wfiich Lister insisted 
on carrying out himself or seeing carried 
out under his own eye; there was much up- 
; r~ in the wards by his having patients 
carried or wheeled into the operating theatre 
for his regular clinical demonstrations; in 
fact, he upset these pious ladies by disturb- 
ing the atmosphere tfiey had created, 
wfiicfi clearly suggested tfiat medical men 
were allowed on sufferance in a hospital to 
do an operation or write a prescription, 
but that it was the nursing which took 
first place, and that the all-important 
points were that the bed should be stiffly 
•tidy, the patient's face shinny clean, and 
that he should say his praye: 

Worse than these two cold douches was 
what John Stewart describes as tfie colossal 
apatfiy, tfie inconceivable indifference, 
shown by the students and surgeons of 
London. The wards of most of the hospitals 
in England at that time stank with the 
hospital air of putrefaction. I remember the 
tin tray placed below an amputated stump 
to catch the dripping pus, and the frequency 
wfth wfiich in the postmortem room we 
saw the amyloid degeneration wfiicfi indi- 
cated tfie patient's long and weary pass 

to the grave with hectic and surgical fever. 

:er's wards were sweet; his dressings, 

when taken off, were free from putrefactive 

odor; they were handed round for confrrrna- 



tion, and I can remember the surprised 
and approving sniff with wfiich the visitor — 
generally a foreigner — confirmed Lister's 
frequent and pleased remark: "You will 
note, gentlemen, tfiat tfie discharge is 
serous and quite sweet." 

Yet Londoners did not come to see this 
revolutionary change, to hear, to smell, 
and to be converted. 

In Edinburgh his class frequently num- 
bered four hundred students; in London 
some ten to twenty might turn up, but 
these gradually fell off. I have heard a care- 
fully prepared, thoughtful, philosophic lec- 
ture, one wfiicfi fielped to lay tfie very foun- 
dation of a physiological understanding of 
our work, delivered by Lister to half a 
dozen men, and many a time I have seen 
firm at work in theatre or ward, accom- 
panied only by fiis own suite. Wfien com- 
pleted, this consisted of six dressers, three 
clerks (who must all have previously served 
as dressers i and his house-surgeon. Each 
office lasted for six months. It was only the 
enthusiasts, or those who had some inkling 
that they were serving a great master, who 
cared to give six to eighteen months to 
receiving this precious instruction in the 
science and principles of surgery. The rest 
cared for none of these things, they were 
indifferent, they were utilitarians, who, 
with what the world might in its foolishness 
call "shrewd common sense," saw that 
Lister's teaching was no use to them, for 
he did not coach them in the subjects 
required for examination, nor hand round 
the tips wfiicfi were to get tfie student 
tfirougfi. Lister noticed tfiat tfiougfi tfie 
London student has an affection for his 
school, he has none for tfie Lniversity of 
London where he graduates, or for the 
7 >yal Colleges where he takes his diploma, 
and hardly any for the city in wfiicfi fie 
studies. The Scotch student has more 
esprit de corps and more/eu sacre in following 
a teacher or getting to the root of a 
subject, i Strange that we have to employ 



100 



Annals of Medical History 



French words to explain these un-English 
traits !) 

The English student is keener on securing 
a diploma with which to earn his living. 
But is he entirely to blame for this? In 
London much is sacrificed to the examina- 
tion system, which encourages cramming, 
stifles any spirit of inquiry or love of 
knowledge for its own sake, and compels 
the teacher to limit his instruction to pre- 
paring the student to pass, not only certain 
examinations, but certain examiners. The 
complete separation of teacher from exam- 
iner also handicaps the student. It is not 
the student who is to blame; it is our faulty 
methods of teaching and examination. Ten 
years later Lister referred to his small 
classes at King's, after his crowded audi- 
ences at Edinburgh, as "a humiliating 
experience." 

But, if students and London surgeons 
were apathetic and short-sighted over the 
revolution being wrought in surgery, it was 
not so with the foreigners. In the entrance 
hall of the old Hospital there was a notice 
board forbidding smoking in English, 
French and German, thus: 

Smoking forbidden 

II est defendu de fumer 

Das Rauchen ist verboten. 

In later years many must have wondered 
when the necessity had occurred for this 
polyglot announcement, for it was rare for 
any Frenchman or German to find his way 
there, and if he did, he was so solitary and 
felt so much the repressive atmosphere of 
our misty island, that he would hardly 
have had the hardihood to light an innocent 
cigarette. But it was different in the 
eighties. When I was Lister's house-surgeon 
in 1883, foreigners poured in from the ends 
of the earth, crowded the entrance hall, 
and there, while waiting for the master, 
they would make the air thick with tobacco 
smoke. Twenty to sixty of them would fill 
the front seats of the lecture theatre; 



indeed, I remember a time when the stu- 
dents complained of this and also of the 
fact that not infrequently Lister gave half 
his lecture in French or German, for he 
could make an extempore speech quite 
easily in either language. This complaint 
came round to Lister's ears, and I remember 
how he took the opportunity of a quiet day 
to refer to it, saying that if the students 
showed as much enthusiasm as the foreign 
visitors he would see to it that they were 
not ousted from the best seats. Like all his 
little corrections, this was said most cour- 
teously and more in sorrow than in anger. 

Among the visitors from overseas we 
made many interesting acquaintances. I 
remember an American surgeon turning 
up one day who told me he had been to 
Vienna to see Billroth, but he did not con- 
sider him equal to a "bully operator" they 
had in Buffalo, from which the visitor came. 
He arrived at the hospital on Saturday 
just before lunch, and I told him Lister 
was not expected till two o'clock. He 
said he would wait, and asked if he could 
not look around the hospital in the mean- 
time. I had the happy thought of turn- 
ing him over to the secretary, whom he 
dragged all over the building and reduced 
to a limp mass before two o'clock. 

When the master arrived promptly, our 
visitor said, "Professor Lister, Sir, I am told 
your wounds heal without suppuration, 
and I've come all the way from Buffalo to 
see them." The ever courteous professor 
said he was sorry, but that no cases required 
dressing that day; that the next day was a 
Sunday, and as he had no class he would be 
changing the dressings in the morning. 
The irrepressible visitor said, "No matter, 
I'll be there." And there he certainly was, 
on the Sunday morning. When all had been 
shown him he exclaimed, "Sir, I was like 
the doubting Thomas in the Scriptures, 
I would not believe without seeing; and, 
like Thomas, I've seen and now I believe. 
Buffalo shall hear of this." Need I add that 



A House-Surgeon's Memories of Joseph Lister 



ioi 



this easy reference, without a prefix, to a 
New Testament saint, and this breaking 
in on the Sabbath morning calm of their 
disciplined wards, caused the caps of the 
High Church sisters of St. John to stand 
straight up from their heads. Lister beamed; 
he had no insular prejudices, and always 
liked the expansive manners of foreigners. 

How different from this chilly English 
reception of 1877 was that extended to him 
only two years later at the International 
Congress of Medicine at Amsterdam! The 
British Medical Journal* tells of Lister's 
reception by the Congress with an enthu- 
siasm which knew no bounds: "When he 
stepped forward to the desk to open his ad- 
dress (which was delivered, with but few 
notes, in improvised French), the whole as- 
sembly arose to their feet, and with deafen- 
ing and repeated rounds of cheers, waving 
their hats and handkerchiefs, hailed the dis- 
tinguished Professor of King's College with 
acclamations renewed minute after minute, 
and time after time, as his name was again 
shouted forth by some grateful and enthusi- 
astic acolyte. This remarkable scene — 
unprecedented, we imagine, in the history 
of medical science — continued for some 
minutes, until Professor Donders, the presi- 
dent, advancing with the distinctive grace 
and dignity for which he is remarkable, and 
taking Lister by the hand, as he stood over- 
whelmed with this magnificent ovation, 
obtained a moment's silence, and addressing 
him said, 'Professor Lister, it is not only our 
admiration which we offer you; it is our 
gratitude, and that of the nation to which 
we belong.' " 

Foreign surgeons attending the next 
International Congress (it was in London 
in 1 881) must have marvelled amongst 
themselves when they heard London and 
British surgeons attempt to cast doubt on 
the principles which Lister had evolved, 
and belittle the results he had given by 
basing his practice upon those principles. 

4 Brit. M. J., 1879, vol. ii, p. 453. 



But when the International Medical 
Congress again met in London in 19 13, the 
light of Lister's good work was shining 
before men, although his body had been 
buried in peace. As we all know, Congresses 
and such-like events are commemorated 
by the issue of a medal. In monarchical 
countries it is a usual custom to engrave 
the head of the reigning sovereign on one 
side of the medal; and the medal of the 
International Medical Congress in London 




The head of Lister which appeared on the International 
Congress of Medicine Medal struck off in 1913, at London. 



in 1 88 1 bears on the obverse the features ot 
Queen Victoria. But in 191 3, it was felt in 
Britain that there was only one effigy 
worthy of being stamped on the medal of a 
Congress in London, and that was the head 
of Joseph Lister. 

My audience will hardly believe me when 
I tell them that in my student days the 
surgeon of one of the largest teaching 
hospitals could always raise an appreciative 
laugh by telling anyone who came into the 
operating theater to shut the door quickly, 
in case one of Mr. Lister's microbes came 
in ! Nor can they credit it that, as late as the 
nineties of last century, another leading 
surgeon had the courageous ignorance to 
publish the results of an experiment he 
made, in which the patients on one side of a 
ward were treated by the older methods, 
i. e., water-dressings, poultices, lint, oakum, 



102 



Annals of Medical History 



strapping ointment and so forth, and those 
on the other side with Lister's "antiseptic 
method." The fact that Lister would never 
publish his statistics was another cause of 
offense. How could he, when he was carry- 
ing out operations never attempted before 
in the history of surgery? 

The first case in which Lister wired a 
fractured patella — I suppose the first case 
in the world in which a healthy knee joint 
was ever opened for such a purpose — was 
in 1877. When I was his house-surgeon I 




Tympanum of Policlinco Umberto 1, Rome. The fagade 
in bas relief shows Lister operating. 



had the honor of bringing together the first 
seven cases which he showed before the 
Medical Society of London in October, 
1883. 5 Some of them were recent and others 
old ununited fractures. All were successful. 
I remember the astonishment with which 
Fellows of the Society tried to feel the 
buried silver wire, and the surprise with 
which they heard that one patient had 
returned to his occupation as a bus-con- 
ductor, and was able to hop off and on his 
step and climb the bus stairs. But others 
were present who were aghast at the un- 
warrantable danger incurred in opening a 
healthy knee, and so running the risk of 
ankylosis, or of amputation and even 
death. One surgeon said that if the next 
case died Lister should be prosecuted for 
malpraxis, and another exclaimed: "C'est 
6 Proc. M. Soc, London, 1884, vol. vii, p. 8. 



magnifique, mais ce n'est pas la chirurgie." 
In his reply Lister simply said that he 
considered that was "chirurgie" which 
saved people's lives. 

The public had not heard his name then, 
nor for many years afterwards. I remember 
soon after starting practice, I thought I 
would strengthen my position in one family 
by mentioning (quite casually of course!) 
that I had been house-surgeon to the great 
Sir Joseph Lister. "Yes," said the patient, 
"a great man; he must have made a pile of 
money out of Listerine!" 

When house-physician I remember telling 
Dr. Lionel Beale that I had just seen Lister 
resect a piece of rib in order to drain a 
pleural empyema. He was horrified and 
said I surely meant that Lister had simply 
tapped the pleura; and when I assured him 
of the fact, he said these surgeons would not 
stop till they had taken out the heart or 
resected the medulla oblongata! 

Ovariotomy results at King's College 
Hospital had been so disastrous that the 
governors had forbidden the staff to under- 
take it. Lister changed all this. 

Slowly, very slowly, but surely, his work 
was winning its way to recognition. But 
even then, as his principles were being 
accepted, recognition was given grudgingly. 
One of his own colleagues, Professor John 
Wood, said that Lister's fame came from 
Germany, that the "Germans were dirty 
people," but that the antiseptic system 
"was not really necessary in |EngIand." 
Efforts to depreciate him were made by 
saying that there was nothing in his 
methods except cleanliness, and late con- 
verts concealed their overdue repentance 
by rapturously embracing asepsis and vaunt- 
ing its superiority over the "antiseptic sys- 
tem," as it was still called. 

But all this was later. In these early years 
of Lister's advent a little personal recollec- 
tion will illustrate how slowly his evangel 
spread, yet how courageously confident he 
was of his mission. I was standing beside 



A House-Surgeon's Memories of Joseph Lister 



103 



him one day on the steps of the hospital in 
1883 as he waited for his carriage to pull 
up, soon after the attack had been made on 
him for opening a healthy knee joint. He be- 
gan by quietly remarking that the day must 
surely come when the profession would ac- 
cept the principles of his methods, "and," he 
added warmly, "if the profession does not 
recognize them, the public will learn of them 
and the law will insist on them." Then, in 
one of those serious, almost solemn, and al- 
ways arresting little speeches, into which he 
occasionally and unexpectedly dropped, he 
placed his hand on my shoulder and added 
pathetically, "Thomson, I do not expect 
to see that day, but you may." Within a 
decade from that day he had left King's 
College Hospital, but not before his mission 
had been fulfilled. We all know the story. 
Sir James Simpson, a colleague of Lister's 
in Edinburgh University, asserted that 
"the man laid on the operating table in one 
of our surgical hospitals is exposed to more 
chances of death than the English soldier 
on the field of Waterloo." 6 

Before the coming of Lister the death 
rate in major operations was from 25 to 40 
per cent; in other words, the chances were 
that one out of every 3 or 4 patients would 
die. These figures included cases which were 
not necessarily serious on admission. Now- 
adays the death rate is 2 to 3 per cent, 
and this is practically made up of cases 
admitted almost moribund, such as ad- 
vanced intestinal obstruction, and others 
operated on in extremis with the faint hope 
of saving life. 7 

Dealing with the surgical revolution of 
the Victorian era, Treves writes: "It is a 
question if any change in human affairs or 
any disturbance in human creeds has ever 
been at once so striking, so thorough, and 



6 "The Works of Sir J. Y. Simpson." Edinburgh: 
1871. vol. ii, pp. 289-392. 

7 W. Watson Cheyne. The Practitioner, 1897. 
vol. Iviii, June, p. 632. 



so unexpected as has been this stirring 
crisis of the healing art. s 

Let us hearken to what one who was at 
no time his pupil said of Lister's work: 

"Lister created anew the ancient art of 
healing; he made a reality of the hope 
which had for all time sustained the 
surgeon's endeavors; he removed the 
impenetrable cloud which had stood for 
centuries between great principles and 
successful practice, and he rendered pos- 
sible a treatment which had hitherto 
been but the vision of the dreamer. The 
nature of his discovery — like that of 
most great movements — was splendid in 
its simplicity and magnificent in its 
littleness. To the surgeon's craft it was 
but 'the one thing needful.' With it came 
the promise of a wondrous future; without 
it was the hopelessness of an impotent 
past." (Treves.) 

In 1892 Lister delivered his last lecture as 
he had to retire under the age limit of 65; 
but he was invited by the Council to con- 
tinue his wards for another year and finally 
left King's College Hospital at the end of 
the summer session of 1893. 

In 1897, the year of Queen Victoria's 
second Jubilee, he was made a peer on 
New Year's Day, his peerage having been 
the first ever conferred upon a surgeon. In 
the following May an address and a dinner 
were offered to him by his old pupils, and I 
had the honor of being the secretary of 
that festival. No less than thirty old 
house-surgeons and one hundred dressers 
were gathered together on that occasion, 
some of them having come from the far 
ends of the earth. Many have told me that 
they have never seen such a manifestation 
of personal esteem and admiration as that 
night when his health was drunk with 
Highland honors. I took the opportunity of 
reminding the chief of his words to me on 

8 F. Treves. The Practitioner, 1897. vol. Ivii, 
June, p. 632. 



104 



Annals oj Medical History 



the steps of the hospital fourteen years 
previously, and I pointed out that he had 
not been imprisoned like Galileo, burnt at 
the stake like Giordano Bruno, or crucified 
like other pioneers of truth, but that we 
had both lived to see the day when his 
principles were universally accepted. Then, 




ml 




Pasteur's Jubilee, 1892. The painting represents Lister 
greeting Pasteur at the Sorbonne. 



drawing a newspaper of the day from my 
pocket, I called his attention to the fact 
that the other part of his prognostication 
had been fulfilled, for this recorded that a 
midwife in Germany had been sent to prison 
for manslaughter, as she had attended a 
confinement without providing herself with 
a proper antiseptic outfit! 

In proposing Lister's health at a Royal 
Society dinner Mr. Bayard, the American 
Ambassador, exclaimed: "My Lord, it is 



not a profession, it is not a nation, it is 
humanity itself which, with uncovered 
head, salutes you." 

What was the personality of this master 
of surgery? He was tall, well built, thick 
chested. He had a profusion of thick iron- 
gray hair, worn somewhat long; except for 
small side whiskers, he was clean shaven. 
I never saw him in any other pattern of 
collar or necktie than those seen in all his 
portraits. You will observe that the upright 
collar has the peaks turned down over a 
black silk bow tie. This was his one and 
only form of what the haberdasher calls 
"neck wear." His costume never varied; 
it was always a grayish pair of trousers and 
a frock coat made of the shiny black mate- 
rial called broadcloth, and nowadays only 
seen on undertakers and country hotel 
waiters. His hands were large and neither 
graceful nor delicate looking; yet he was a 
steady, firm and deliberate operator. With 
the least exertion he perspired freely, and 
it was always one nurse's duty to stand 
behind him ready armed with a clean 
towel, to which he frequently turned during 
an operation to mop his streaming forehead. 
His voice was low and musical, with a 
rather attractive hollowness about it, and 
with an occasional slight stammer. His 
manner was generally serious, but relieved 
by what Dr. John Stewart calls his "gentle, 
amused and somewhat pensive smile." His 
manner to many had a certain aloofness 
about it, and even his life-long disciple, 
Watson Cheyne, confesses that Lister al- 
ways inspired him with a certain sense of 
awe. I myself always felt that his soul was . 
like a star and dwelt apart. Yet he com- 
manded not only veneration, respect and 
admiration, but a feeling of trust and devo- 
tion which could only be explained by the 
nobility and sincerity of his character. 
Though separated from him by the broad 
Atlantic for thirty-four years, a former 
pupil could write: "It is beyond my power 
to express the feelings of reverence and 



A House-Surgeon's Memories of Joseph Lister 



105 



love I have for Lord Lister, or to say how 
much his life has been to me." (John 
Stewart, 191 2.) For my part, I can only 
say that no teacher, no friend, no man I 
have ever known has impressed me as 
Lister has done. To none of them do I feel 
the debt I owe to him for the example of his 
veracity of thought and word, his patience 
under persecution, his constancy in the 
pursuit of truth, his eagerness to instruct 
his pupils, his long-suffering with stupidity, 
his tenderness to the poor and his gentleness 
to the sick and maimed. He was universally 
courteous and, by treating others with 
respect, even his most violent critics, he 
appeared to be able to elicit the same con- 
sideration in return. 

As an illustration of his devotion to our 
profession and the high esteem of which he 
considered it worthy, I will read you a few 
sentences from an address he gave to the 
newly qualified students in a Graduation 
Address in 1878: 

"If we had nothing but pecuniary 
rewards and worldly honors to look to, 
our profession would not be one to be 
desired. But in its practice you will find 
it to be attended with peculiar privileges; 
second to none in intense interest and 
pure pleasures. It is our proud office to 
tend the fleshly tabernacle of the im- 
mortal spirit, and our path, if rightly 
followed, will be guided by unfettered 
truth and love unfeigned. In the pursuit 
of this noble and holy calling I wish you 
all Godspeed." 

When anything went wrong with a 
patient, and when a patient died, Lister 
was touchingly cast down and sorrowful. I 
remember an incident when he was working 
at the radical cure of hernia. Before his 
time, and particularly in King's College 
Hospital, efforts to effect this were attempt- 
ed by a complicated method of sub- 

9 Sir W. Fergusson, "A System of Practical Sur- 
gery." London: 1870. 5th Ed., p. 646. 



cutaneous wires. 9 Well, Lister was going to 
try, probably for the first time in the world's 
history, the open method on a somewhat 
emphysematous subject. The twenty-four 
hours before the operation were very foggy; 
I went over the patient's chest carefully 
(having previously been house-physician, 
I may remark); and when Lister arrived, 
I reported that the man was very bronchitic 
and that he might like to defer the opera- 
tion. After making some inquiries and 
hearing that the patient's pulse and tem- 
perature were normal, he decided to go on 
with it. The man died three days later from 
bronchitis and pulmonary edema. I do not, 
of course, quote this to emphasize my own 
perspicacity, but to illustrate how Lister 
acted under the circumstance. He selected 
as subject for his next lecture, "The medi- 
cal care of surgical cases," narrated the 
history of the bronchitic man, and his deep 
grief that he had not paid more attention 
to the warning of his house-surgeon. There 
are few professors who would have had 
such sincerity, courage and magnanimity. 
But his biographer relates that though 
he felt things very keenly at the time, a 
certain buoyancy soon restored his equa- 
nimity and forward-looking temperament. 
He writes thus when on a holiday: "I have 
the happy faculty of being able to throw 
off all thoughts of work for the time being." 
Real idleness was not congenial to him. 
He fished, but as his biographer says, he 
was a diligent amateur but never an expert. 
His efforts at skating were more like a 
scientific pursuit, and he could do 8's and 
3's, — but of small dimensions. He took a 
fair share of vacation and, on his holidays, 
like all large minded men I have met, he 
could be light hearted and boyish. But 
complete idleness never appealed to him; 
on his holidays there were usually proofs 
to correct, or addresses to prepare; on the 
Continent he practised and improved his 
very good French and German; during 
winter visits to Spain between 1887 and 



io6 



Annals of Medical History 



1889 he acquired a certain amount of 
Spanish; he was devoted to walking and 
excursions; he was interested in botany and 
bird-life; and he could always fall back on a 



ipsissima verba you will not "see Lister 
plain," but you will come into very close 
contact with his noble character. It reads 
as follows: 




*L > ^^r---~>--*-~~^i .^t-i-^-^Ci 







Facsimile of a letter written by his wife and signed by Joseph Lister. 

We are fortunate in possessing a perfect 
pen-picture of the master in imperishable 
verse written by W. E. Henley, who was at 
one time his patient in the Edinburgh 
Infirmary: 



pocket-volume of Horace, Dante or Goethe. 
Another trait of his character was his 
invariable gentleness and sympathy with 
the humblest or roughest of his hospital 
patients. He seldom referred to a patient 
as "a case," but introduced his remarks with 
such kindly terms as "this poor fellow," or 
"this good woman" or "this little chap." 
To demonstrate this to everyone here 
to-day I will hand round a letter written 
by Lister to the house surgeon who preceded 
me, Dr. R. G. Lynam, now of Oxford. You 
will note that this letter is entirely concerned 
with the interests of his students and a 
hospital patient, for whom he shows a touch- 
ing consideration. He sent the letter to the 
Hospital by special messenger, there being 
no telephone in these days. In reading his 



"His brow spreads large and placid, and his eye 
Is deep and bright, with steady looks that still. 
Soft lines of tranquil thought his face fulfill — 
His face at once benign and proud and shy. 
If envy scout, if ignorance deny, 
His faultless patience, his unyielding will, 
Beautiful gentleness, and splendid skill, 
Innumerable gratitudes reply. 
His wise, rare smile is sweet with certainties, 
And seems in all his patients to compel 
Such love and faith as failure cannot quell." 

Lister lived most of his life and died a 
member of the Church of England. But he 



A House-Surgeon's Memories of Joseph Lister 



107 



was brought up a Quaker and it has been 
well said of him that "he belonged to a 
Society the members of which called all 
men Friends; and now in truth because of 
his inestimable beneficence and service to 
mankind, all men the world over call him 
Friend." (Sir Michael Foster.) 

Lister was blessed with a loving and 
devoted wife. She was a daughter of Pro- 
fessor Syme, whom he had served as 
house-surgeon in Edinburgh, and she ap- 
peared to have no thought or interest 
beyond her husband. She not only loved 
and shielded him in every way, but entered 
intelligently into all his work and re- 
searches; helped him in his studies; worked 
in his laboratory; wrote his letters; and 
often when I arrived at his house early in 
the morning to go with him to a private 
operation, I would find Mrs. Lister pre- 
paring and checking off his instruments. 
In their pleasures, as in their work, they 
were united. They were inseparable com- 
panions on all his holidays, and in the 



numerous Continental trips he loved to 
make. It was while on one of these in Italy 
that his wife died, after a very brief illness, 
in 1893. They had no children; and after 
his wife's death Lister was a very lonely 
man. 




Original model for Sir Thomas Brook's medallion of 
Lister, in Westminster Abbey. 




Lady Lister. 



His last years were saddened by slowly 
failing health. On the tenth of February, 
1 91 2, he died at Walmer, a little fishing 
village on the English Channel, which 
looks across the Goodwin Sands to the 
shores of France. 

He would have been buried at West- 
minster Abbey had he not left clear instruc- 
tions that he wished to be laid to rest beside 
his wife in West Hampstead Cemetery. 
Before this took place a public funeral 
service was held in Westminster Abbey on 
February 16, 191 2, and the pall-bearers 
were representatives of the Order of Merit, 
the Royal Society, the Royal College of 
Surgeons, the Universities of London, Edin- 
burgh and Glasgow, the Lister Institute, 
and King's College Hospital, which was 
represented by his first house-surgeon in 
London and faithful disciple, Sir Watson 
Cheyne. 

In the north transept of Westminster 



io8 



Annals of Medical History 



Abbey there is a marble medallion of 
Lister's bust, placed near to those of the 
great scientists Darwin, Stokes, Anderson 
and Watt. It is extraordinarily like "the 
Chief," as his students called him in Edin- 
burgh. 

Those who attended that impressive 
requiem in the Abbey will never forget the 
stately pomp and circumstance of a public 
funeral service, when not only the nation's 
representatives, but delegates from all the 
world over manifested their mourning for 
a man who had made humanity his debtor. 



But more soul-stirring still were the 
words of Handel's anthem, so peculiarly 
applicable to our dear Master, as the music 
of it rolled through long drawn aisle and 
fretted vault: 

"When the ear heard him, then it blessed him, 
and when the eye saw him it gave witness of 
him; he delivered the poor that cried, the father- 
less, and him that had none to help him. Kind- 
ness, meekness and comfort were on his tongue. 
If there was any virtue, and if there was any 
praise, he thought on those things. His body is 
buried in peace, but his name Iiveth forevermore." 




Armorial Bearings of Lord Lister, the 

Serpent "of yEscuIapius appearing for the 

first time on the quarterings of a Peer of 

the Realm. 



THE OXFORD PHYSIC GARDEN 1 



By SIR D'ARCY POWER, K. B. E., M. B. OXON. 2 



LONDON, ENGLAND 



I HAVE recently been engaged in tran- 
scribing the commonplace books of 
the Rev. John Ward which are 
preserved in the Library of the 
Medical Society of London. The volumes 
are sixteen in number, and an account of 
them appears in my presidential address 
to the Medical Society of London. 3 

Ward was born in the year 1629 at 
Spratton in Northamptonshire, the elder of 
the two sons of John Ward, M. A., of 
Pembroke College, Oxford, by Dorothy, a 
daughter of Richard Pargeter. John Ward 
the elder was a gentleman of property who 
became a lieutenant in Colonel Apple- 
yard's Regiment of Foot at the beginning 
of the Civil War, was taken prisoner by the 
Parliamentary forces at Naseby in 1645, 
and probably died soon afterwards, for 
John Ward the younger makes no mention 
of his father, though he speaks of his 
mother as living some years later. The 
younger son, Thomas, became rector of 
Stow-in-the-WoId, a small market town 
situated in the Cotswolds, a few miles from 
Oxford. 

John Ward, the writer of the notebooks, 
went to Oxford in the middle of "the broken 
times," as they were called by Anthony 
Wood, when the University lists were badly 
kept. It is not surprising therefore that his 
name does not appear in the registers. He 
states, however, that "I was presented 
Mr. of Arts about the year 1652 in Easter 
term. Anthony Ratcliffe and Philip Gerard 
and Mr. Temple with us." Reference to 
Foster's "Alumni Oxonienses" shows that: 



Anthony Ratcliffe of Magdalene College, 
Cambridge, matriculated 1st October 1645, 
was incorporated 16th March 1648-9 stu- 
dent of Christ Church by the visitors; B. A. 
23rd May 1649; M - A - 6th May 1652; 
Canon (of Christ Church Cathedral, Oxford) 
nth February 1 680-1; Chaplain to Henry, 
Earl of Arlington; Vicar of Leigh, Kent, 
1661; died June 1703. 

Philip Gerard, son of William of London, 
gent. Christ Church, matriculated 29th 
January 1646-7, aged 13 from Westminster 
school B. A. 8th July 1649; M.A. 6th May 
1652." 

"Mr. Temple" was John Temple of Pem- 
broke Hall, Cambridge, where he was 
admitted 30th January 1645-6; student of 
Christ Church 1648 by the visitors; B.A. 
8th July 1649; M.A. 6th May 1652; vicar 
of Haughton 1660 and of Portslade, Sussex, 
1669. 

Ward also speaks of "our table at Christ 
Church," i. e., the master of arts table in 
the hall where the resident masters dined 
together. It is fair to assume, therefore, 
that Ward matriculated at Christ Church 
at the end of 1646 or the beginning of 1647, 
graduated B.A. in July, 1649, an d took the 
degree of M.A. on May 6, 1652. It is 
interesting as a sign of the times in which 
he lived that although his father had 
suffered in the Royalist cause, two of his 
friends, viz., Ratcliffe and Temple, had 
been admitted to Christ Church, Oxford, 
from Cambridge by order of the Par- 
liamentary visitors, so that they must have 
had Parliamentarian sympathies. 



1 Read before the Ashmolean Society, Oxford, 
May 13, 19 19. 

2 President of the Section of the History of Med- 
icine, the Royal Society of Medicine. 

3 Tr. M. Soc. Lon. The Rev. John Ward, M.A. 
Vol. 40, 1917. 



WARD S GRADUATION THESIS 

The second volume of Ward's notebooks 
begins on May 27, 1652, and gives in full 
his thesis "An Estate an hieme plura sunt 
oblectamenta. Affirmatur quod sestate." It 



109 



no 



Annals of Medical History 



is a good example of the Austin disputations 
which preceded admission to the degree of 
master of arts. Such a disputation or exer- 
cise was performed by every bachelor of 
arts once a year unless he had obtained a 
dispensation. It was held on any Saturday 
in term time between the hours of one and 
three o'clock in the choir of the University 
Church and was presided over by the 
masters of the schools, who received either 
a drachma (4d., equivalent to about ten 
cents) or a pair of gloves as a fee. Three 
days' notice had to be given by affixing the 
subject of the disputation and the names of 
the disputants on the doors of the Church. 
A text of these Austins is now so rare 
that it is worth while to reproduce Ward's 
disputation in extenso so far as it can now 
be read. It runs as follows: 

AN RESTATE AN HIEME PLURA SUNT OBLECTA- 
MENTA? 

Affirmatur quod sestate 
"Coram quern quaeritis adsum et ego, 
Auditores, de sestate pace vestrae perora- 
turus interim tamen qui quidem instante 
hieme ingravente frigore, tantum non 
congelasco, verum enimvero ni male 
memini Autumnus adhuc se sistit. Ideo- 
que nondum favorem vestrum in tantum 
declinasse autumor quin ad blandiente 
vultu conatus meos quales sint, satis 
superque foveatis; sed esto; adsit canora 
hiems nihilominus tamen aliquales sestatis 
Iaudes scriptitare nee solaecismum erit 
nedum intempestivum. Imprimis autem 
Iiceat mihi modo Iubet per totum oblec- 
tamentorum Zodiacum dico quasi pede 
pertransire neque hac in re ullam ag- 
noscam Cancri tropicum dicimus ideo 
sestatem esse earum omnium deliciarum 
nutricem, quas obstetricante sole dudum 
vere peperit materna tellus quas aeque 
vobis recensere impar sum, ac flores, 
fruges, herbasque tandem delectissime 
sitas enumerare adeo cujusve generis 
amcenitatibus faecundat ista tempestas, 



ut cuilibet in ccelis rutilanti suuminterris 
videatur respondete aemulum pulcher- 
rimos scilicet flosculorum quasi constel- 
Iationes ita ut haud facile dictu utrum 
hie an illic major pulchritudo, major 
suavitas herba quaelibet suum habet 
oblectamentum suum denique colorum 
vel ipsae veneris in ipsissimae formae ad- 
versi omen neque hi sistendum est sed 
ulterius suum uberrimum sinum repandit 
nobis exhilerans aestas neque intra quot- 
vis vel dicendi vel sentiendi campos 
coangustantur ejus oblectamenta; sensus 
quilibet suum habet objectum proprium 
vividum torridum et opprime satis adap- 
tatum; gustus sapidas suas et succulen- 
tas qualitates; olfactus suos spiritus revi- 
tescentes, visus colores speciosos eximie 
variegatos; harmonias suas dulcissime 
sane concinnatos habet etiam auditus 
ipse, imo, tat tantiza exuberat orna- 
mentis ut necessum esse philosophis 
videatur occultos concessisse qualitates, 
tales scilicet quales melius capiat sensus 
nullum percipiat Organon ita ut super- 
fcetare videatur aestas etsi precedet in 
excesse tamen pervadere, neque solius 
sensus cervum et ingens intellectus hunc 
temporis efflorescunt jucunditates. Unde, 
quaeso, oriuntur subtiles istae intellectus 
praecisiones et verum etiam a se invicem 
sublimationes et abstergationes nisi ab 
aestivo verum conspectu et virescente seu 
maturo statu hinc, hinc se sursum pro- 
vocat intellectus et quamvis sit nobilior 
ipsius animae facultas, haud minimum 
tamen ejus auxilium huic debet tempes- 
tati. 

"Quis philosopher usquam, mi Antago- 
nista, dedisset nobis discrimen inter essen- 
tiam rei et existentiam nisi emblemata 
sunt quasi de hoc sumptis notionibus; 
hieme ergo his notata sunt. Quasi inesse 
in suis causis, aestate autem extra causas 
in meo opinione quantum ergo rosa in 
hieme ab eadem in sestiva differt tanto 
tamen aestatis gaudia hiemalibus istis 



The Oxford Physic Garden 



in 



praeferenda. Hyems naturae ponit obiens 
quosdam et repagula ut suos neuriquam 
excutiat Iaetantes foetus conglaciantur 
omnia et meatus ejus tanto frigore tant- 
isque velaminibus obstruuntur ut intus 
hospitantes ejus voluptas nequaquam in 
apricium proferat. 

"Quicquid nisi geras quicquid denique 
voluptatis pluvia afferantur fotum hoc 
habeamus et per me licet omnibus oblec- 
tamentis hoc sequente hieme et sic deni- 
que abunde fruatur, Antagonista, cui 
modo penes me essent assignare domicil- 
ium, esset ei circiter polum arcticum aut 
plaga sui borealis ubi cerebrum et cere- 
bellum ejus, cranii meningumque vice 
glaciali quodam integmento incrustantur 
et nassus obstergentur et denique tenebrae 
frigus fimusque et hiemis comites satis 
superque ei adessent. Verbo, dicam, quod 
hiemali tempore aliquanto supplet artifi- 
cium illud ipsum a natura estate perve- 
nit; haec a priori isto et defaecationi caloris 
fonte fomentemur ilia carbonarios illos 
putidos et male olentes focos in hunc 
finera videamus, hue omnia valemus 
vigore quodam naturali donata illuc 
autem condita variisque modum ad 
earn insimulanda prseparata ita ut 
nullo negotio asseramus siqua hiemi 
voluptas adest eandem meram esse 
aestatis umbram; . . . nac plus veree in 
se Iaetitiae quam aestatis habet quod 
tamen minimum. 

"Testor vos, juvenes, an melius imo 
jucundius vobiscum si res habet cum 
dilucalo satis vesticos vestras matutino 
frigore hiemali commutetis postea quoque 
redivivo spiritu digitos vestros refocilletis 
quanquam alios si res habet profecto 
tunc temporis tantum abhorretis istam 
philosophiam vel ipsam animam esse 
totam in toto asserventem ut vix eandem 
in qualibet parte hospitari judicetis; 
quicquid igitur aggerat, Antagonista, ne- 
mo nisi Scythia, nisi Hyperboreus aut 
Muscovita aut qui veras et aestivos tell- 



uris amoenitates nescivit sed solum vig- 
ente bruma et pontum et terram vider- 
unt astrictis pedibus ibit in istam sen- 
tentiam. 

"Qualis, quaeso voluptas in manuum 
frictionibus, pedum pulsationibus toti- 
usque corporis ab ingravente frigore quo- 
tidianis concussionibus; quorum haec nisi 
et vitales et animales spiritus intus ad 
fontem attrahentes tota hac agitatione. 
Praeberentur haeccine voluptas hoccine ob- 
Iectamentum; quis unquam somniavit has 
Iaetitias, hac tempestate oriundas, nisi 
misenda quaedam metamorphosi summos 
dolores in summam salutem commutare 
queat. Taceo morbos istos tunc temporis 
ut plurimum eheu grassentes, taceo tan- 
tum ilium sanguinis fluxum et effluxum, 
unde tot oriuntur pessimal obstructiones, 
taceo denique poros istos totius corporis 
spiramenta graviter obstructos unde nisi 
uti scio oriatur boni nisi ventriculi . . . 
itos; taceo denique contrarios aestatis 
fructus scilicet, salutem hilaritatem 
totius composui vigorem imo ipsissimam 
vitam. Bruma enim est quasi omnium 
interitus dum aestas vegetabilia, animalia 
ipsa quoque homines pristino vigore, 
calore, et eras redintegrare videtur ; super- 
sideam igitur, auditores, hsec in re ul- 
teriorem vobis restituere panaegyria me 
sudores, me corripiant aut vos invadat 
nimium frigus et nullus dubito quin vos 
omnes, si non in praesentiarum dudum 
tamen, si tarn chara maneat materia 
combustibilis non solum pedibus sed 
et toto corpore in meam ibitis sententiam. 

DIXI 
RICHARD LOWER 

Ward continued to live in Christ Church 
after he had taken his M.A. degree, interest- 
ing himself in what would now be called 
natural science. He speaks repeatedly of 
"Dick" Lower, who is better known to us 
as Richard Lower, one of the most gifted 
of the band of Oxford men who founded 



112 



Annals oj Medical History 



the Royal Society. It was Lower who helped 
Willis in those dissections of the brain and 
nerves which have made his name immortal, 
and there is very little doubt that Ward 
helped Lower. At this time Lower was 
working especially at the color and move- 
ment of the blood and chyle, though his 



the Vicarage of Stratford-on-Avon where, 
he remained until his death in 1681. For 
a year or two he lingered in Oxford, paying 
repeated visits to London; in these years 
he interested himself in botany; and it is 
to this period of his life that I am asking 
your attention. 




Fig. 1. The Oxford Physic Garden, from Loggan's "Oxonia Illustrata," 1675. 



name is more familiar to anatomists than 
physiologists, owing to the adoption of the 
term "the tubercle of Lower" for the thick- 
ening of the lining membrane on the pos- 
terior wall of the right auricle of the heart 
between the openings of the two venae 
cavae. Lower moved to London and ob- 
tained a large practice, much of which he 
afterwards lost on account of his Whig 
tendencies. 

Ward, like Lower, found life in Oxford 
comfortable enough until the Restoration. 
The old order then returned and Ward 
determined to leave the University. He 
came to London, therefore, undecided 
whether to enter the Church or obtain a 
degree in medicine from a foreign university 
and practice medicine. The Church pre- 
vailed, and after some inquiries he bought 



Most of Ward's botanical knowledge 
was gathered from three persons whom he 
mentions repeatedly: Jacob Bobart, who 
was clearly his teacher; Dr. Modesy, of 
whom he always speaks in terms of great 
respect, and Ned Morgan, with whom he 
was intimate. 

JACOB BOBART 

Jacob Bobart was the gardener at the 
Oxford Physic Garden, and I need hardly 
remind you that this garden [Fig. i] 
was a benefaction of Henry, Lord Danvers, 
Earl of Danby, and that it was opened with 
befitting ceremonial on 25th July, 162 1, 
just forty years before the time of which 
we are now speaking. Jacob Bobart [Fig. 2] 
had been appointed horti praejectus in 1632 
and for his services in this capacity "the 



The Oxford Physic Garden 



ii3 



Earle of Danby doth covenant for him, his younger (1641-1719), who was appointed 



heires and assignees, to pay yearly to Jacob 
Bobart (The University Gardener) the 
summe of £40 in consideration of his 
dressing, manureing and planting the sayed 
garden." 



Professor of Botany at Oxford in 1683. 

The elder Bobart appears to have been 
one of the Oxford characters of his 
generation. He had a long beard which on 
days of rejoicing he used to have tagged 




- ; , - ■ 



Fig. 2. Jacob Bobart, from an engraving by D. Loggan. 



Of Bobart we know that he was born in 
Brunswick probably in 1596 and died on 
February 4, 1679-80, being buried in the 
Churchj r ard of St. Peter's-in-the-East. In 
1648 he published anonymously a cata- 
logue of sixteen hundred plants then under 
his care. He revised this catalogue in 1658 
with the help of his son, Jacob Bobart the 



with silver, and he was usually accompanied 
in his walks by a goat instead of a dog. 
Anthony Wood reports of him that "Jacob 
Bobart senior, keeper of the Physic Garden, 
Oxon., used to wear a long beard, whereupon 
Mark Colman, a melancholy distracted 
man, sometime a singing man at Ch. Ch. 
walking in the physic garden catcht fast 



H4 



Annals oj Medical History 



hold of his beard crying 'Help! Help!' upon 
which people coming in and enquiring of 
the outcrie, Colman made reply that 'Bobart 
hath eaten his horse and his tayle hung out 
of his mouth.' " 

Bobart's salary was sometimes seriously 
in arrear, and he complained after the death 
of the Earl of Danby that he had received 
nothing for several years. It is not sur- 
prising, therefore, that on great occasions 
he was not above receiving presents of 
money for showing the garden. Thus on 
May 4, 1669, Cosmo di Medici, Prince 
of Tuscany and son to the Grand Duke, 
"went and saw the Physic Garden and 
being there (Bobart the Keeper having 
presented him with a very fine nosegay in 
the morning) the said Bobart spoke a speech 
in the German tongue to him, which he 
liking and his garden, he gave him a 
reward." A memorial of this visit still 
remains in the form of a view taken by an 
artist in the suite of Cosmo. The original 
is in the Laurentian Library at Florence 
and there is a photograph of it in the Bod- 
leian Library. The view is taken from 
Cherwell Hall at the end of Cowley 
Place. 

Amongst other triumphs of Bobart's art 
were two yew trees which grew close to the 
entrance gate of the garden. These trees 
he had clipped into the form of giants, and 
by a very bad pun the wits of the time 
called them his yewmen of the guard. 
They seem to have been replaced in Log- 
gan's engraving [Fig. 1] by two statu es. 4 



For a long time I was unable to identify, 
the person whom Ward always calls "Dr. 
Modesie" or "Dr. Modesy" until by piecing 
together the information he gives about 
him I arrived at the conclusion that he 
could be none other than the famous 
gardener, Dr. Robert Morison. 

ROBERT MORISON 

Morison [Fig. 3] was born at Aberdeen 
in 1620 and graduated in the University 
of Aberdeen in 1638. He devoted himself 
at first to mathematics and Hebrew, being 
intended for the ministry. In taking part 
in the Civil War on the Royalist side he 
received a wound of the head while fighting 
at the Brigg of Dee. He afterwards went to 
Paris and took the degree of M.D. at 
Angers in 1648. He was then received into 
the household of Gaston, Duke of Orleans, 
in the capacity of physician upon the 
recommendation of Vespasian Robin, the 
French King's botanist. It is probable that 
his botanical tastes were fostered by his 
association with Abel Bruyner and Nicholas 
Marchant, the keepers of the Duke's gar- 
den at Blois. He held the appointment of 
physician, to which a handsome salary was 
attached, from 1650 until 1660, and it was 
perhaps at this time that he changed his 
name from Morison to Modesi as being 
easier of pronunciation by the French 
tongue. While in the Duke's service he 
was sent to Montpellier, Fontainebleau, 
Burgundy, Poitou, Brittany, Languedoc 
and Provence in search of new plants. 



4 Messrs. Vines and Druce in their interesting 
"Account of the Morisonian Herbarium," (Oxford 
1914, p. xvii), quote Baskerville's account of Bobart: 
"Here I may take leave to speake a word or two of 
old Jacob who now is fled from his Earthly Paradise. 
As to country he was by birth a German, born in 
Brunswick that great Rum brewhouse of Europe. 
In his younger dayes, as I remember, I have heard 
him say he was sometime a soldier by which Im- 
ploy and Travail he had opportunities of Aug- 
menting his knowledge, for to his native Dutch he 



added the English Language and he did under- 
stand Latine pretty well. As to fabrick of body he 
was by nature very well built (his son in respect of 
him but a shrimp) tall, straite and strong with 
square shoulders and a head well set upon them. 
In his latter dayes he delighted to weare a long 
Beard and once against Whitsontide had a fancy 
to tagg it with silver, which drew much company 
in the physic Garden. But to save you further 
trouble view his shadow in this Picture." [See 
Loggan engraving Fig. 2.] 



The Oxford Physic Garden 



115 



Morison became known to King Charles 
II while at Blois, and at the Restoration 
he was appointed senior physician, King's 
botanist, and superintendent of all the 



audiences at a table covered with botanical 
specimens placed in the middle of the 
physic garden. The lectures were given 
twice a year, in May and September, each 




V"c Morjfone / tra jju:utf cortfuwjfre major 
(.7. r ; ... Pa-onium quam SM'trafie ilctilta'. 
"nfc liii jpdbruun.Vh<x!ius coruedit \|>ol]o 
Law&mtuesC caput quttUbet furbil tuo 



Fig. 3. Dr. Robert Morison, from a portrait prefixed to the third volume of his works. 



royal gardens in England at a salary of 
£200 a year and a house. He was incor- 
porated M.D. Oxon. from University Col- 
lege in 1669, an d m the same year he became 
Sherardian Professor of Botany in the 
University. He lectured to considerable 



course consisting of three lectures a week 
for five weeks. While on a visit to London 
he was struck in the chest by the pole of a 
coach as he was crossing the Strand from 
Northumberland House to St. Martin's 
Lane and his skull was fractured by falling 



n6 



Annals oj Medical History 



on a stone. He was carried to his house in 
Green Street, Leicester Square, where he 
died the next day, November 10, 1683, with- 
out regaining consciousness. He was buried 
in the church of St. Martin's in the Fields. 
Morison appears to have been a good 
botanist with a clear notion of genus and 
species and a conception of the family 
which is almost identical with that now 




Fig. 4. Photograph of a page of John Ward's diary.* 

* The volume from which this page of Ward's diary 
is taken has a colophon: "This book was begunne 
ffeb.21.1661; and finished April ye 24th. 1663; att 
Mr. Brooks his hous in Stratford uppon Avon in 
Warwicke-shire." The page contains the often 
quoted entry about the death of Shakespeare. 
What stuffi is your Lithuanian hydromel. 
With ye Spuma of Beer method 1 haue heard of 
some great cures done 
What were ye Teutonick Order; 



held. He seems, too, to have been one of 
the first to make use of dichotomous keys 
to specific characters, and he denied the 
existence of spontaneous generation. 

Anthony Wood gives an interesting side- 
light upon Morison when he says that 
upon the occasion of the visit to Oxford 
of the Duke of York (afterwards King 
James II) with the Duchess of York on 
May 18, 1683, "Dr. Robert Morison the 
botanick professor speaking an English 
speech was often out and made them laugh. 
This person, though a master in speaking 
and writing the Latin tongue yet hath no 
command of English as being much spoyled 
by his Scottish tongue." He seems to have 
been more fortunate on September 9, 1680, 
for he presented — no doubt in Latin — an 
address to the Electoral Prince Carolus, 
Comes Palatinus ad Rhenum, Dux Bavarian, 
to Convocation for the degree of Doctor of 
Physic. 

EDWARD MORGAN 

"Ned Morgan," who will be mentioned 
so often is, I believe, the Morgan referred 
to by Evelyn in his "Diary" under the date 
June 10, 1658, where there is an entry: 
"I went to see ye Medical Garden at 
Westminster, well stored with plants under 
Morgan a very skilful botanist." This 
Westminster Medical Garden, the site of 
which I have not been able to identify, is 
said to have existed and to have been used as 

Shakespeare Drayton and Ben- Johnson had a merry 
meeting and it seems drank too hard for Shakespear 
died of a feavour there contracted, 
hares in ye winter time turne white all ouer Livonia. 
Whether a Justice of peace after hee is made high- 
sherif is ipso facto outed from being a Justice until 
hee gets a new Commission, itt is affirmed yt hee is; 
whether a Lord may at all bee arrested or not. I 
haue heard not; A Lord cannot bee arrested by a 
warrant from a Justice or a supplication out of ye 
Chancerie, only ye Lord Chancelour may graunt a 
sub-poena to ye Lord. 

A fine barrs only Issue: a common recoverie barrs all 
Remainders in tail as Brothers & whosoever. 



The Oxford Physic Garden 



117 



a physic garden by the Society of Apothe- 
caries before they established the well 
known one at Chelsea. At any rate in 1676 
the Court of Assistants of the Apothe- 
caries Company agreed to take over the 
lease of the Westminster Garden from Mrs. 
Gape, the tenant, in order to remove the 
plants it contained to the newly founded 
garden at Chelsea; and in 1677 "Mr. 
Morgan the gardener asked for increased 
'consideration' for keeping the garden and 
for his plants." Morgan may, therefore, 
have acted as gardener at the earliest 
period of the Chelsea garden; but there is 
no farther allusion to him in the Court 
Minutes of the Society of Apothecaries, 
and Pigott is usually said to have been 
the first person put in charge of the garden. 
The last number of The Bodleian Quarterly 
Record 5 contains an interesting note by Mr. 
G. Claridge Druce entitled "Edward Mor- 
gan's Hortus Siccus." He says that the 
Bodleian Library contains three large folio 
volumes which up to 1845 were kept in the 
Botanic Garden Library. They are bound in 
rough calf and each contains about 160 
leaves. They are entered in Bernard's 
Catalogue (1697) as "Hortus Siccus sive 
CoIIectio Plantarum ab ipso Eduardo Mor- 
gano facta ordine alphabetico, bis mille 
circiter plantarum species exhibens." The 
work seems to have been begun in 1672, and 
there is a letter from "Thomas Thornes to 
Edward Morgan Iiveinge att Bodesclen" 
offering anything in Leweny (Hall in Den- 
bighshire). Aiton ascribes the introduction 
of Phlomis purpurea to Morgan. Mr. Druce 
also states, on the authority of Mr. J. Grif- 
fith, the Welsh archaeologist, that the family 
of Robert Wynn (a branch of the Gwydur 
family) intermarried with the Morgans of 
Golden Grove — a seat about 4 miles from 
Rhuddlan — and there was a son who became 
a Bencher of the Middle Temple in 1597 
and died in 161 1. He had a son — Edward 
Morgan — who died without issue. This 
5 The Bodleian Quarterly Record, vol. 2, p. 227. 



son was probably the Ned Morgan who 
was Ward's friend. 

ward's allusions to botany 

Ward's first reference to botany is found 
in the book which "was begunne about 
November ye 13th. 1660 in London." 
Fig. 4, which is photographed from one of 




Fig. 5. The Elsing Spital garden from Agas' Map of 
London, dated 1560. 



the pages, will show the peculiarities of the 
handwriting. 
The earliest entry about botany runs: 

"Palyurus or Christ's Thorne I saw itt 
in ye physicke garden and haue, I think, 
a piece of itt in my Botanologicall Booke; 
itt is very sharp. They fain yt ye Thorny- 
Crowne wch Christ wore was made of 
this. 

"Bobart ye physick gardiner hee had a 
feavour an. 1660 and after itt his hands 
and his feet pilld (peeled); his very flesh 
came off. 

"This present year 1660 Bobart says 
hee never saw nor never knew so many 
things in flour as yr was before ye 20th. 
day of ye month of Januarie. 

"Five sorts of fritillaries Jacob saies 
they have in ye garden; wee saw ym in 
flour March ye 23 1661 in ye Garden. 

"The 28th. March 1661 wee went to 
Shotover to find Ianaria by Jacob's 
directions but found none but fragarias 



u8 



Annals oj Medical History 



and Cerefolium silvestre and some few 
others. 6 

"White Anemones found on Shotover 
Hill. 

"I was uppon New College wall on ye 
17th April 1 66 1 to find ruta muraria 
(Adianthum album) but could find none 
but much adianthum nigrum (Capillus 
veneris) was there. 

"The foye grape is very large but sour 
and bears little and one of the worser sort 
as Jacob told mee, though sometimes you 
shall have a branch of 2 pound weight. 

"Jacob found two chestnut trees wild 
toward Newberie and many hee hath 
seen growing in Sion-CoIIedge garden 
which brought chestnuts to perfection." 




Fig. 6. The Garden of Sion College, from the plan of the 
City of London, dated 1 720. 



Sion College, now situated on the Thames 
Embankment close to Blackfriars Bridge, 
was then in London Wall, where it was 
built in 1623 on the site of the Priory of 
Elsing Spital — a religious house consisting 
of four canons regular whose duty it was 
to minister to the blind. 

Agas' map, published in 1560 [Fig. 5] and 
the plan of the City issued in 1720 [Fig. 6] 

6 In other words he went to look for soap wort 
and found strawberries and chervill. 



both show a large garden bounded by Cole- 
man Street on the east and London Wall 
on the north, which possibly represents this 
garden. 

"Jacob hath a very prettie Orchis 
which resembles a Bee. I saw itt May ye 
4th. 1 66 1. 

"Dentaria (Tooth Violet) I saw but itt 
was somewhat withered; hee told mee 
there was one at Cornbury park yt. 
spred extremely." 

Cornbury Park is near Charlbury and 
was a part of the Wychwood forest. Its 
present owner — Mr. Vernon Watney — 
lately offered to store and brick up any 
treasures from the Bodleian Library which 
might need protection from air raids. 

"There is a gentleman in Worcester- 
shire wch. hath made very considerable 
progress in altering flowers artificially, 
as Jacob told mee, he knows not his name. 

"That sedum in Bobart's house hath 
hung up these 8 years only by taking of 
ye cloth now and yn and anointing itt 
with oil once a quarter and so putting 
itt on againe. 

"Hot Beds made with horse dung a 
foot deep in very fine sifted and fat mold. 

"There are 8 kinds of sorrel; ye com- 
mon, ye greater ffrench; ye great Ger- 
man; ye little round Ieafd ffrench; ye 
sheep's and three Lujulas. This Jacob 
told mee. Parkinson only knew of two 
'the common sorrell familiar enough in 
many places of this land the other a 
strangere as farre as I can Iearne and onely 
cherished in the gardens of those that 
are curious. This groweth in divers 
shadowie places about Sevill in Spaine 
and in gardens at Mompellier.' 

"May ye 9th. An. Dom. 1661 att ye 
physick garden. Almonds in ye physic 
garden come to some kind of ripeness. 

"Oil of Almonds made only by powder- 
ing ye Almonds and pressing of them; 
such almond oil is to bee drawne fresh. 



The Oxford Physic Garden 



119 



"There bee 3 sorts of plantaine, ye 
Common wch. is broad-Ieafd; ye quin- 
qunervia Latifolia wch. is hairy and ye 
narrow-Leafd Ribwort. 

"Out of Grubbs wch. is a kind of short 
worme comes ye rose-flie as Jacob told 
mee. 

"A spider with her eggs I saw in ye 
Physick garden May 27 1661. A vine 
grew 26 feet in one year, Jacob himself 
measured itt. 

"The great red Oreleance grape grows 
in ye Crosse In (n) yard in Oxford; itt is a 
very good grape." 

The Cross Inn stood in Cornmarket 
Street on the Carfax side of what is now 
Market Street. The building was of great 
antiquity and had the whipping post just 
in front of its doors, and a celebrated pump 
supplying petrifying water close to it. 

"Lychnis noctiflora flowers only in 
ye night, begins about 8 o'clock. Malva 
horaria lasts but 8 hours; Cistus angli- 
canus — Lilium dierum — ye flowers last 
only for one day, Jacob informed mee 
truly. 

"Bobart had a bunch of grapes once 
ripe on ye 5th. August wch. hee presented 
to ye Swedish Embassador yn att Oxford, 
they usually not coming till ye Latter 
end of August or beginning of September. 

"Jacob Bobart spake with Dr. Modesay 
and says of him ye whole world yields 
not ye like man, hee never heard a man 
talk att yt. gallant rate in his life. Hee 
shewed ym all his designs in ye new 
Garden; There are to bee walks in itt of 
thirtie foot wide as hee saies. 

"The Aloes in ye Physic garden wch. 
is mucronated is ye Indian; ye other 
wch they use to hang up in ye houses is 
ye Spanish one. Tribulus terrestris is in 
Mr. Howard's garden att Dorking, Jacob 
saw itt and_many_other_rarities." 

Evelyn paid two visits to these gardens. 



On the first occasion he writes in his "Diary" 
under the date August 1, 1655: "I went to 
Dorking to see Mr. Cha. Howard's amphi- 
theatre garden or solitarie recesse, being 15 
acres inviron'd by a hill. He shew'd us 
divers rare plants, caves and an elabora- 
tory." The second visit was on September 
13, 1670, "to visite . . . Mr. Charles 
Howard at his extraordinary garden at 
Dipden (Deepdene)." 

"Jacob saies hee thinks Parkinson hath 
500 plants more yn Gerard only Gerard's 
paper is better & his Cutts better, they 
being dulled ere they came to his hand; 
2 sorts of Adiantum wch. yet I know not. 

"Bobart spreads white sand under his 
plants yt hee may discover when ye seed 
falleth. 

"I have heard Jacob say they planted 
ye raisins but itt bare fruit only like ye 
Currant. 

"There is ye Rhenish grape in ye Physic 
Garden. 

"English ffigs I saw ripe at ye Physic 
Garden September 21 1661 some were 
presented to ye Chancellor. They were 
good to eat. 

"Lentils commonly soused in some 
parts of Oxfordshire. Jacob told mee they 
call ym Dily ; hee could never see it nor I. 

"Jacob saies hee hath seen the double 
pomegranate as high as their garden 
wall with 500 Balaustines or flowers uppon 
itt at once. 

"Wee had a bout at simpling ye 2 
October 1661 when I had full satisfaction 
about ye Hieracium ac (cipitrina) nigrse; 
Chondrilla foliis; and sonchus radicatum 
and ye knapweeds (Centaurea), ye media 
is that wch. grows with a tuft or thrumb 
in ye top; ye spicata and minima or 
herba impia." 

Much interesting lore attaches to the 
herba impia. Pliny, 7 says: 

"Concerning the herba impia, which is 
7 Pliny, lib. 24, cap. 19. 



120 



Annals oj Medical History 



of a hoary colour and white withall, it 
resembleth in show the Rosmarie, rising 
up with a maine stem, leafed and headed 
in the manner of a Cole-stocke; from 
which principall bodie there grow foorth 
other small braunches, every one being 
little tufts or heads rising and mounting 
above the mother stocke (whereupon they 
called it in Latine Impia, for that the 
children overtopped their parents; yet 
there be others who have thought it 
rather so called, because there is no beast 
will touch or taste it) . This hearb if it be 
ground between two stones, waxeth as 
hot as fire, and yeeldeth a juice which is 
excellent for the squinancie, if the same 
be tempered with milke and wine. But 
this is straunge, that is reported more- 
over, namely, that whosoever hath once 
tasted of this hearbe shall never be 
troubled with that disease, and therefore 
they used to give it in wash and swill to 
swine, but Iooke which of them refuse to 
drink of this medicine shall die of the 
said squinancie. Some are of opinion that 
in birds nests there is some of this hearbe 
commonly set and twisted among other 
sticks whereby it commeth to passe that 
the yong birds never be choked, gobble 
they their meat as greedily as they will." 

SIMPLINGS 

The "simplings" or "herborizings" were 
essential parts of the botanical teaching of 
medical students when botany, rather than 
anatomy was used as the basis of medical 
education. They were systematised in Lon- 
don as early as 1633 under the auspices of 
the Society of Apothecaries. In 1634 there 
was a travelling Club of Botanists with 
Thomas Johnson — the editor of the second 
edition of Gerard's "Herbal" and the 
translator of Ambroise Pare's surgical 
works — as Convenor or at any rate as 
Recorder. The Socii Itinerantes, as they 
called themselves, published by his hand a 
little account of their travels and dis- 



coveries under the title "Mercurius Botan- 
icus sive plantarum gratis suscepti itineris 
Anno MDCXXXIV descriptionum earum 
nominibus Latinis & Anglicis &c." (Lond. 
Excudebat Thorn. Coyes MDCXXXIV). 
The outing was evidently successful, for a 
second part appeared in 1641, from which 
it appears that the party had travelled into 
Wales in July 1 639 going by way of Ayles- 
bury, Henley-in-Arden, Wolverhampton 
and Stockport to Flint, Carnarvon and 
Snowdon. They crossed the Menai straits 
and returned by Ludlow, Gloucester and 
Oxford. 

Mr. Claridge Druce 8 points out that 
Edward Morgan was of the party and 
acted as interpreter while they were in 
Wales (sed nobis antiquse Linguae Britan- 
nic se ignaris opus erat interprete, in quern 
finem Edoardum Morganum rei herbarise 
etiam studiosum nobis adjunximus, eique 
sumptus prebuimus). 9 

The herborizings reached their zenith in 
London about 1798, when they were under 
the active superintendence of Thomas 
Wheeler, who led the expeditions from the 
time of his appointment as horti prxfectus 
at the Chelsea Physic Garden, when he 
was aged twenty-four, until they were 
abandoned in 1834, when he was eighty. 

There were five herborizings yearly which 
the apprentices of the Apothecaries Society 
were enjoined to attend; two in May, one 
in June, one in July and one in August. 
Each apprentice attending was allowed a 
shilling for breakfast and a plain but sub- 
stantial dinner; and in 181 6 it was resolved 
by the Society of Apothecaries that "an 
allowance should be made of a bottle of 
wine among four or a bottle of cyder be- 
tween two but that no porter or other malt 
liquor should be allowed except table beer 
and that tea be given as Usual." The 
apprentices assembled punctually at six 

8 The Bodleian Quarterly Record, vol. 1, p. 227. 

9 "Mercurii Botanici pars altera." London : 
1 64 1, p. 3, ad finem. 



The Oxford Physic Garden 



121 



o'clock in the morning at St. Bartholomew's 
Hospital, where Mr. Wheeler held the office 
of Apothecary, or as it would now be 
termed, of "Resident Medical Officer." 
The excursions were made along well- 
known routes necessarily within walking 
distance of the City: sometimes to Hamp- 
stead Heath by way of Islington; some- 
times along the Kent Road to 
Greenwich and Blackheath; at 
other times to Battersea by way of 
Lambeth and so along the river 
bank to Putney, Hammersmith and 
Richmond. Some well-known inn 
served as the rallying point on 
each occasion, and after dinner 
the plants which had been gathered 
by the way were exhibited, named 
and had their uses explained. 

In Oxford I do not think they 
had quite died out in my own time. 
Professor Lawson and Professor 
Ray Lankester used to invite one 
or two undergraduates like myself 
to walk over to Dorchester with 
them on a Sunday to look for 
Myxomycetes in the tanyard and to 
pick and name the various wild 
flowers on the way. We lunched 
either there or at Shillingford and 
walked home in time for Hall. 



It is evident that Jacob Bobart was not 
very well about this time, for there is the 
following prescription for "A Plaister laid to 
Jacob's wrists; — R; — Half an Orange poun- 
ded in a mortar, currance (currants) as 
much, sal prunellae 3 ii. M. ft. emplastrum." 
(At this time and for many years previously 
plaisters were applied to the wrists of 




Fig. 7 



"There is an old lime tree in 
Stow wood as I heard Jacob 
say. Jacob told mee he used in 
his quartane Lap. Contraerva and a 
little posset-drink; hee took itt a little 
before ye fit and sweat mightily. 

"The contrayerva stone here men- 
tioned was made of calcined hart's horn, 
prepared red coral, pearl, white amber 
crabs eyes and contrayerva root all mixed 
together and made up into balls with a 
solution of gum Arabick. It was used in 
place of Gascoign's powder as a diapho- 
retic. The jelly of vipers' skins was added 
and it was wrapped in gold foil." 



. Essex House Garden, from Hollar's engraving reproduced in 
Ogilby and Morgan's twenty-sheet plan of London. 



patients just as they are now applied to 
their backs.) 

"I saw ye Simnel gourd in ye physick 
garden wch. being prickt full of holes and 
some barley-cornes put into itt they will 
grow out and show very prettily. 

"Tribulus quercus foliis. I saw much of 
itt in Lambeth Jan. 16 1661. 

"I saw chestnuts and almonds in their 
shells but ordinarily sold in London by 
hucksters. 



122 



Annals oj Medical History 



"I was at Essex House gardens Jan. 
22 ( 1 66 1-2) where ye Dutches of Somer- 
set Iivd. I saw no great matter but only 
Oranges and myrtles. Ye plot is hand- 
some and a wilderness but nothing of 
any great raritie planted as I saw." 

The general appearance of these gardens 
is seen in Fig. 7, which is taken from an 
etching by Hollar in Ogilby and Morgan's 
twenty-sheet plan of London. Essex House 
was situated in the Strand just west of the 
Temple and adjoining Arundel House. The 
names of the two houses are still preserved 
in Essex Street and Arundel Street, Strand, 
which occupy their site. 

"One Mr. Baker is Gardiner att Syon 
House." [Sion House is situated on the 
Thames just opposite Kew Gardens. 
Evelyn in his "Diary" writes of it: "July 
7 (1665) To London to Sr. Wm. Coventrie 
and so to Sion where his Majesty sat at 
Council during the contagion; when busi- 
ness was over I viewed that seate belong- 
ing to the Earle of Northumberland, 
built of an old nunnerie of stone and 
faire enough but more celebrated for the 
garden than it deserves; yet there is 
excellent wall fruit and a pretty foun- 
taine; nothing else extraordinarie."] 

"One Mr. Ball keeps a great garden 
about Brainford (Brentford) of flowers 
and a Nurserie likewise. 

"A Boon-Crysson, Mounseer John and 
Mon Dieu, all French pears. Staphesacre, 
Dr. Modesey hath itt. ('Itt is not easily 
preserved in cold Countries,' says Dr. 
Lovell in his 'Compleat Herball,' pub- 
lished at Oxford in 1665.) 

"Feb (166 1 -2) Dr. Modesay says hee 
never studied grasses and mosses. 

"Dr. Modesay told Ned Morgan yt 
ye Duke of Orleance sent but 4 persons 
with 4 men and horses to seek out strange 
plants and they went toward ye Alps and 
Italy and in all this journey they found 
but 3 very strange plants and yt voyage 



cost ym more — ye Duke — Dr. Modesay 
thought, yn all ye Gardens did beside. 

"I was with Dr. Bruce att his chamber 
behind ye New Exchange, allso with Dr. 
Modesie att ye King's Garden who 
showed us some of his very rare plants as 
Marum Syriacum (Mastick), Crithmum 
spinosum (The Samphire) and Barba 
Jovis 10 with others; hee commends Ned 
Morgan's for ye best collection of plants 
in England; hee seems to bee a morose 
man. 

"Dr. Modesy says yt Lysimachia pur- 
purea spicata is an euphrasia both by 
flour and seed, ye 2 ways by wch. hee 
judges. 

"Dr. Modesy says yt. yt. wch wee call 
Chelidonium majus and minus are neither 
of ym so but Ranunculus both. 

"ffabius Columnus Dr. Modesy does 
much commend. 

"Sycamore, Dr. Modesie saies, is Acer 
majus as appears by ye seed. Hee judges 
of all plants, what tribe they are of, by ye 
seeds; a good way indeed." 

The following information was probably 
also the result of a conversation with Dr. 
Modesy : 

"Rablais is a kind of romance writt 
by one Rablais — a Spanish physician — 
and ye way of itt was to requite ye book- 
seller for a book wch. hee had formerly 
wrote wch. did not sel. Rablais was a 
physitian (Ward adds subsequently) and 
wrote ye romance of Pantagruel in rec- 
ompense to him for a Book wch hee had 
before, wch would not sell. 

"At Dr. Modesy 's garden September ye 
1 st. 1662; itt is a very rare (fine?) thing 
to discourse with him. I saw there 
Jacobcea crithmifoliis ; Capparis Fabago; 
Cappadiis; Capsicum poly gala; Valentina 
Clusii and many other rare plants. The 
Doctor entered into a most noble and 

10 The barba Jovis or silver bush had only recently 
been introduced into England. 



The Oxford Physic Garden 



123 



elaborate discourse about ye true way of 
reducing plants by their seeds to a tribe 
and yt hee had a treatise to yt purpose." 

Amongst the rare plants mentioned above 
which Dr. Modesy showed to Ward are some 
of the Capparidese, and it is noteworthy 
that Morison's name is preserved in con- 
nection with this order, for a West Indian 
genus of the caper family is still called 
Morisonia. The Jacoboea crithmifoliis was 
named by Morison in honor of James 
Duke of York, to whom he dedicated it. 

"Ned Morgan told mee of a person yt 
hee knew yt would undertake to raise 
500 plants more yn ever was in England 
in one or 2 yeeres if hee had but In- 
couragement. I suppose hee meant Dr. 
Modesie. 

"Three sorts of Leucojum Bulbosum, 
Ned Morgan told mee hee had. A very 
pretty Iris wch. hee calld persica. I 
saw itt in his garden; Ye flowers open 
with a mouth like snapdragon. 

"Dr. Modesie is acquainted well with 
Dr. Bonie and seldom goes abroad with- 
out him. 

"Dr. Dale and another had a designe 
to amend ye phytologia Brittanica to 
adde somewhat and take out somewhat, 
but Dr. Modeseye's coming to Towne 
itt's thought hindered itt. 

"Ned Morgan tels mee next Dr. 
Modesy, Dr. Dale, Dr. Merit and Mr. 
Goodyer are ye best botanists of their 
age in London, ye 3 last were about a 
new phytologia 3 or 4 years agoe Dr. 
Modesie coming to towne Ned Morgan 
thinks they left off." 

ROBERT DALE 

Robert Dale was a Bachelor of Arts of 
Magdalen College, Oxford, who practised 
medicine at Stourbridge in Worcestershire 
and was admitted an Extra-Licentiate of 
the College of Physicians of London on 



October 1st, 1663. No record of his attain- 
ments in botany seems to have survived. 

CHRISTOPHER MERRITT 

Christopher Merritt was a more dis- 
tinguished person. He was born at Winch- 
combe in Gloucestershire on Feb. 16, 16 14, 
and was admitted a student of Gloucester 
Hall, Oxford — the present Worcester Col- 
lege — in 1631. He afterwards migrated to 
Oriel, whence he graduated B.A. in 1634; 
but he returned to Gloucester Hall and took 
his M.B. and M.D. degrees. He was 
admitted a Fellow of the College of Phy- 
sicians of London in 1651 and was one of 
the original Fellows of the Royal Society. 
He was a friend of Dr. William Harvey, 
who nominated him the first Librarian at 
the College of Physicians then in Amen 
Corner, where he lived free of rent and 
taxes from 1654 until the Great Fire in 
1666, the salary of the office being twenty 
pounds a year. The College lost heavily 
by the fire and it was thought that perhaps 
Merritt, as the resident Librarian, might 
have saved more of the books and val- 
uables. He was deprived of his place and 
took action in the law Courts. The College 
defended its position by saying that as there 
were no duties to perform there was no 
need to pay a Librarian. Much ill-feeling 
was aroused, and the College eventually 
expelled Dr. Merritt, who died in Hatton 
Garden on August 19, 1695, an d was 
buried in the Church of St. Andrew's, 
Holborn. 

I can find no trace of Mr. Goodyer, the 
third of the botanists mentioned above 
except that he went to Wales as a member 
of the Socii Itinerantes and was a good 
friend and able assistant to Thomas Johnson 
in producing the "Mercurii Britannici pars 
altera." 11 

"A cinara spinosa et aculeata Ned 
Morgan showed mee. 

II "Mercurii Britannici pars altera," London: 1641. 



124 



Annals oj Medical History 



"Muscus filicinus is winged like feme. 
Much of it gathered in Hamden woods. 

"Gramen Innatans and fluviatile Ned 
Morgan told mee and Burri (?) as it hath 
a yellow spike on top. Ilex cocciger grew 
in ye privy garden. Itt was a tall tree 
and blown down about such time as ye 
King was beheaded. 

"4 sorts of Ilex att Ned Morgan's; 
Ilex coccigera; 2. Ilex glandifera; 3. Ilex 
aktae-foliis; 4. ye common. 

"Ned Morgan told mee yt hee had 
seen Ginger grow in England like Iris. 

"Your Red Mint wch. grows com- 
monly in water is Sysymbrium aquati- 
cum; and ocimastrum some call Sisym- 
brium nosterti.(?) 

"Dr. How hath put out a piece showing 
what plants Parkinson stole out of a 
manuscript of Lobel's wch. never was 
put out but came by chance to Dr. 
Modesy's hand." 

(Again I am unable to discover any facts 
about this Dr. How who seems to have 
convicted Parkinson, the great herbalist, 
of plagiary from Lobel.) 

"What bilberries are? Whether like a 
black cherry or not as I heard some 
affirme. 

"Whether Hart cherry is not so called 
because it is like ye Heart. 

"White saxifrage roots very small. 

"Remember to see pomegranates, ye 
fruit itself." 

This is one of the numerous instances 
illustrating Ward's bad memory. He is 
constantly reminding himself of what he 
should do. An amusing instance occurs 
when he gravely makes the entry: 

"Remember to excommunicate ye two 
persons yt committed adultry; ye woman 
yt turned Catholic and to warn drunk- 
ards and ye like." (This occurs a few years 
after the time which is now under con- 
sideration, and when he was Vicar of 
Stratford-on-Avon.) 



"Adianthum album much upon Wind- 
sor wall in ye Castle. 

"I saw a Medler tree at Ned Morgan's; 
hee also had ye physic nut but itt was 
gone; and ye yellow Jessemine but dead." 
The physick nut is the strychnos Nux 



vomica. 



"The humble plant shrinks and falls, 
ye sensible only shrinks up." 

(These facts are clearly derived from 
Bobart who was working about this time 
at the mechanism of the sensitive plant.) 

Parkinson recognises two varieties of 
sensitive plant. The one he calls the herb 
of life or love; the other the Mimicke, 
mocking or sensitive plant. 

"The admirable propertie of the herb 
of love is that if any shall touch it with 
their hand and some say that if any man 
doe but breathe upon it, it will presently 
draw it selfe together, and if one would 
take it into their hand it will close to- 
gether as if it were dead. But that which 
is more admirable is, that if they shall 
withdraw their hand it will quickly after 
as it were revive againe and spread it- 
selfe as it was before it was touched, and 
this it will doe many times in a day if it 
be touched and let alone againe without 
touching. Other properties it is sayd to 
have as to restore Virgins that have been 
defloured, if ye will beleeve, to procure 
love betweene man and woman, and as 
Acosta saith he was informed by an 
Indian physicion of good credit, that he 
would cause any woman to be at his will 
and pleasure, so that he would but de- 
clare her name and use it (or rather abuse 
it) as he would appoint him, but the fact 
being unlawfull, he refused the con- 
dition." 
The sensitive plant Parkinson had seen 

"as it grew in a pot at Chelsey in Sir 
John Danvers Garden where divers seeds 
being sowne therein about the middle of 
May 1638 and 1639 some of them sprang 



The Oxford Physic Garden 



125 



up to be nearly half a foot high. . . . 
This plant is said not to be so quicke in 
apprehension as the former. . . . This 
upon touch or breathing there on would 
not fall downe as in the former and rise 
againe but is said to fall away, that is 
the lower leaves and so likewise the 
upper leaves if they were touched againe, 
but the stalk also would breake off and 
fall down upon the touch or breathing." 

" Fraxinella, " says Ward, "bears a 
brave large spiked flower much like pars- 
ley rosted in a pidgeon's belly. 

"I saw at Ned Morgan's ye Bead tree 
(Zizipha) because ye seeds are like beads, 
also Glaux maritima and Cruciata marina. 

"I was with Ned Morgan July ye 3rd. 
where I saw some pretty plants as absyn- 
thium arborescens and absynthium in- 
sipidum et inodoratum; itt had neither 
taste nor smell; a very pretty plant; very 
like common wormwood. 

" 'Flore Incarnato' is (to be translated 
by) with a blushing kind of flower. 

"There was a pretty hedge of Spanish 
broom. 

"Remember all in my garden." 

I have no doubt that by this time Ward 
had been inducted into the Vicarage of 
Stratford-on-Avon, and that with the par- 
sonage there went a garden. His duties at 
any rate did not leave him time for botany, 
as there is very little further mention of the 



subject in its scientific aspects after this last 
entry. 

I have read this paper to you this evening 
for two reasons. In the first place it appeared 
to me that living in Oxford you would be 
interested in the mention made by Ward of 
some of our predecessors here; and also 
because it is only by learning at first hand 
what subjects employed the thoughts of 
those living at any given period that it is 
possible to reconstruct their lives. Ward 
lived in Oxford, as I have said, during one 
of the most active periods in its history 
and, as he was a faithful reflection of his 
surroundings, we are able to gather what 
his great fellow graduates were doing and 
thinking. While he was in residence Wilkins 
was considering the problem of perpetual 
motion; Harvey and Bathurst the develop- 
ment of the chick; Wallis the circulation of 
the blood; Willis and Lower anatomy in 
relation to the brain and the heart; Bobart 
botany; Boyle was advancing physics; God- 
dard was doing something to make medicine 
scientific; and Barlow of the Bodleian was 
advancing the knowledge of Oriental lan- 
guages. Ward interested himself in the work 
of all and more especially perhaps in that 
of Boyle, whom he calls persistently "Bog- 
hil," so that as in the case of Dr. Modesy 
I had some difficulty in identifying him 
under the disguise of phonetic spelling. I 
hope on some future occasion to treat of 
him as I have now treated of Bobart. 



ITtt 



MODERN COMMENTARIES ON HIPPOCRATES* 

By JONATHAN WRIGHT, M.D. 

PLEASANTVILLE, N. Y. 

PART II 



AFTER reading the "Airs, Wat- 
ers and Places," one is aston- 
ished at the emphasis laid upon 
them by Hippocrates as factors 
in the etiology of disease, and upon reflexion 
one is also surprised that modern medicine 
has laid upon them so little stress. 

Whoever wishes to investigate medicine prop- 
erly, should proceed thus: In the first place to 
consider the seasons of the year, and what effects 
each of them produces (for they are not at all 
alike, but differ much from themselves in regard 
to their changes). Then the winds, the hot 
and the cold, especially such as are common to 
all countries, and then such as are peculiar to 
each locality. We must also consider the 
qualities of the waters, for as they differ from 
one another in taste and weight, so also do they 
differ much in their qualities. In the same 
manner, when one comes into a city to which 
he is a stranger, he ought to consider its situa- 
tion, how it lies as to the winds and the rising 
of the sun; for its influence is not the same 
whether it lies to the north or the south, to the 
rising or to the setting sun. These things one 
ought to consider most attentively, and con- 
cerning the waters which the inhabitants use, 
whether they be marshy and soft, or hard, and 
running from elevated and rocky situations, 
and then if saltish and unfit for cooking; and 
the ground, whether it be naked and deficient 
in water, or wooded and well watered, and 
whether it lies in a hollow, confined situation, 
or is elevated and cold; and the mode in which 
the inhabitants live, and what are their pursuits, 
whether they are fond of drinking and eating 
to excess, and given to indolence, or are fond 
of exercise and labor and not given to excess 
in eating and drinking. 

From these things he must proceed to inves- 
tigate everything else. For if one knows all 
these things well, or at least the greater part 
of them, he cannot miss knowing, when he 
comes into a strange city, either the diseases 
peculiar to the place, or the particular nature 



of common diseases, so that he will not be in 
doubt as to the treatment of the diseases, or 
commit mistakes, as is likely to be the case, 
provided one had not previously considered 
these matters. And in particular, as the season 
and the year advances, he can tell what epidemic 
diseases will attack the city, either in summer 
or in winter, and what each individual will be 
in danger of experiencing from the change of 
regimen. 

At first, making all due allowance for 
the things Hippocrates did not know and 
discounting as much as is possible the large 
amount of knowledge we think we possess, 
there still remains a discrepancy which it 
is difficult to understand between the 
ancient attitude towards these factors in 
the environment of man and our own way 
of looking at things. In the course of the 
last century this antithesis has become 
much accentuated. There is no doubt this 
is due to our acceptance, which on the whole 
has continued to become constantly more 
absolute, of the doctrine that the germ 
plasm of living things is, at least in many 
of its ontological manifestations, but little 
modified by the environment which is 
comprehended in the title of this Hippo- 
cratic book. Moreover, in the latitude where 
high civilization reigns today as it has never 
reigned anywhere nor at any time before, 
man is shielded from the influences of the 
environment in very many ways that were 
unknown to the balmy Mediterranean when 
life for the most part was spent out of doors, 
subject not only to the actions of the air, 
the water and the wind, but to the inimical 
influences in the way of contagion common 
but unsuspected then, and more effectually 
guarded against now. Nevertheless, not- 
withstanding this difference in the incidence 



Part I of this article appeared in vol. ii, no. i. 
126 



Modern Commentaries on Hippocrates 



127 



of the hostile forces of nature once unim- 
peded, and now more successfully resisted, 
it was rather in the theoretical attitude of 
thinking men toward biological phenomena 
that we are to seek the reason for that defer- 
ence once paid to the environment of man 
of which we are now so forgetful. 

We have turned from the environment 
of man to his innate heredity for an expla- 
nation of so many things which befall him 
that theoretically we are unmindful of the 
fact that the incidence of disease is chiefly 
dependent on the former. Singular to say, 
in modern medicine science lays the practi- 
cal emphasis on the environment so far 
as it is inclusive of man's microbian enemies 
and looks coldly on the innate factors of 
heredity when expressed in the term of 
"systemic predisposition," yet this is what 
in other biological fields receives the chief 
attention. The vast preponderance of mod- 
ern medical thought centers in man's 
microbian environment and the reaction 
of the somatic cells. The minimum of 
attention is devoted to the relation of these 
things to the germ plasm, though of course 
these two aspects of the biology of disease, 
the environment and the germ plasm in 
their relation to one another are not entirely 
ignored. 

It may seem stretching the argument 
beyond the limits to which it applies to 
adduce it as a cause of the modern neglect 
of climate in the etiology of disease. For the 
ancients, indeed, until within a century at 
farthest, the two aspects were inseparable. 
What hurt the stamina of the individual 
injured the stamina of the race. We get 
some glimpses of the stern law of nature 
in Herodotus which led Malthus and Dar- 
win and Spencer to the realization of the 
struggle for existence, the survival of the 
fittest or natural selection, the several 
ways of expressing the same factor, as the 
mainspring of the theory of evolution. But 
though clearly expressed it was a spark 
in the days of Herodotus which kindled no 



fire, a seed which fell on unsuitable soil, 
a dead-born child, just as most germs of 
mighty things which every day and in every 
age are missing their proper environment. 
Burnet 11 thinks that Anaximander had an 
idea of what is meant by adaptation to 
environment and survival of the fittest, 
and that he saw the higher mammals could 
not represent the original type of animal. 

For this he looked to the sea, and he naturally 
fixed upon those fishes which present the closest 
analogy to the mammalia. . . . His proof that 
man must have been descended from an animal 
of another species has a curiously modern ring. 
The young of the human species require a pro- 
longed period of nursing, while those of other 
species soon find their food for themselves. If, 
then, man had always been as he is now he could 
never have survived. 12 . . . Animals appeared 
when the primitive liquid earth dried up, 
and were originally fish in form. Then some of 
them, adapting themselves to their new en- 
vironment, became land animals. 13 

One of the Darwinian arguments for the 
modern doctrine rests upon an observation 
of this kind. Anaximander included man also 
in his scheme of evolution. 

We get the same germ of natural selection 
in the wild theory of Empedocles, the dream 
of the true paranoiac. Curiously enough, 
Empedocles seems to have separated his 
stages of evolution into, first, the time in 
which various parts of animals arose sep- 
arately, and then the time when the scat- 
tered limbs united. But they united in an 
entirely unsymmetrical way, so that no 
harmony could be established between their 
movements or their functions. We infer from 
his esoteric philosophy that these two stages 
were governed by the dominant influence 
of Aphrodite or Love, identified usually as 

n Burnet, John, " Early Greek Philosophy," 2d. 
edition. London: Adam and Charles Black, 1908. 

12 Burnet, John, "Greek Philosophy." Pt. 1. 
Thales to Plato. London: Macmillan and Co., 
Ltd., 1914. 

13 Windelband, W., "History of Ancient Philos- 
ophy." Tr. by Herbert Ernest Cushman. 2d. ed. 
New York: Charles Scribners' Sons, 1906. 



128 



Annals of Medical History 



chemical attraction by modern commen- 
tators. There then came a third state when 
strife destroyed the unity of the sphere. 
This is reminiscent of concepts in many 
if not in all religions, the battles of the 
Titans, the contest of Ormuzd and Ahriman, 
of the ^schylean Prometheus and of the 
Miltonic Satan. The Golden Age of Hesiod 
is succeeded by the strife in the subsequent 
epochs of his Theogony. Thus Empedocles, 
too, bears evidence of the impress made 
on his budding rationalism by myth and 
the conventional beliefs of his day. Then 
came the real world, his fourth stage in 
which the sexes and species had been sep- 
arated. New animals no longer sprang from 
the fertile mud of the marshes, but now 
they are produced by generation. Thus 
facts and theories live and thrive not 
because they are mirrors of truth, but be- 
cause they fit into the environment. One 
can scarcely forbear to indulge in the jest 
that this is a true example of the "survival 
of the fittest." Even Burnet 14 betrays a 
sense of humor in the attempt when he 
quotes from Aristotle: 

In both these processes of evolution, Empe- 
dokles was guided by the idea of the survival of 
the fittest. Aristotle severely criticises this. 
. . . One curious instance has been preserved. 
Vertebration was explained by saying that 
an early invertebrate animal tried to turn round 
and broke its back in so doing. This was a 
favourable variation and so survived. 

The Darwinian giraffe acquiring extra 
cervical vertebrae by reaching successfully 
after the tufts in the lofty palms is a mere 
refinement of this idea. 

To return to Herodotus, 15 (III, 108) he 
says in his pious way, forestalling criticism 
by saying that the Providence of God 
proves itself wise! 

14 Burnet, John, "Early Greek Philosophy." 2d 
ed., London: Adam and Charles Black, 1908. 

16 Herodotus, "Histories of Herodotus," Tr. by 
Henry Cary. New York: D. Appleton and Com- 
pany, 1904. 



Whatever creatures are timid, and fit for food . 
have been made very prolific, lest the species 
should be destroyed by constant consumption; 
but such as are savage and noxious, unprolific. 
For instance, the hare, which is hunted by all, 
beasts, birds, and men, is so prolific that it 
alone of all beasts conceives to superfetation, 
having in its womb some of its young covered 
with down, others bare, others just formed, 
and at the same time conceives again. Such, 
then, is the case. Whereas a lioness, which is 
the strongest and fiercest of beasts, bears only 
one once in her life. 

When, however, the theories of generation 
were spread abroad in the pre-Hippocratic 
world of Greece there was innate in them 
another germ of Darwinism, pangenesis, 
which in the decades succeeding the era of 
Hippocrates was clearly set forth by Aris- 
totle: 16 "The semen comes from all parts 
of the body, sound from the sound parts 
and unhealthy from the unhealthy parts. 
If then children with bald heads are born 
to parents with bald heads; and children 
with blue eyes to parents who have blue 
eyes; and if the children of parents having 
distorted eyes squint also" . . . then arti- 
ficial deformation of the head through 
pressure is apt to produce long headedness 
in the children of those who were submitted 
to the custom prevailing among certain 
people in infancy. Aristotle is inventing 
nothing of his own but he is setting forth 
the ideas of others when he further says : 

Some assert, that the seed is emitted from the 
whole of the body. . . . Mutilated animals are 
generated from mutilated parents; for they 
say, that in consequence of a part being wanting, 
the seed does not thence proceed; and that it 
happens the part is not generated from which 
it does not proceed. In addition to these argu- 
ments, they adduce the similitude of offspring 
to parents. For as the whole body is generated 
similar to the whole, so, likewise, the parts to 
the parts. (Book 1. Chap, xvii.) 

16 Aristotle, "On the Generation of Animals." 
In his Treatises, tr. by Thomas Taylor, vol. iv, 
p. 241, London, 1808. 



Modern Commentaries on Hippocrates 



129 



In the flitting thought of Herodotus and 
in the more circumstantial elaboration 
of Aristotle, in natural selection and in 
pangenesis we have the two leading ideas 
of the method of evolution as they existed 
in the mind of Darwin. Lesser men who 
have come after him have for the most part 
had room for only one of them in their 
cranial cavity. Men who preceded him by 
some 2500 years were in the same plight, 
but the pangenesis germ sprouted in their 
minds, while in the minds of those who fol- 
lowed and out-Darwined Darwin the germ, 
minute as we have seen it in Herodotus, 
Anaximander and Empedocles, became the 
inconceivable germ plasm of Weissmann 
in his early days. I am free to say that I 
do not perceive that Burnet and especially 
Gomperz are justified in drawing the parallel 
quite so closely between the old and the new 
evolutionary theories. The ancient nature 
philosophers, Parmenides, Alcmaeon and 
Empedocles, like Galton, all drew the simple 
conclusion that the resemblance of mental 
and physical characters of the offspring 
depends on the proportion in which the seed 
of the parents enters into the constitution 
of the offspring, ^tius reports that Em- 
pedocles believed that the offspring were 
affected by maternal impressions, a firmly 
held doctrine of more modern times — or 
by the fancy of the woman at the time of 
conception — the basis of the philosophical 
story of Goethe — Elective Affinities — "for 
oftentimes," he says, "women fall in love 
with images and statues and bring forth 
offspring like these." 17 

So we recognize the vagaries as well as 
the other details in the evolutionary doc- 
trine of the day which are useful in allowing 
us to perceive the very quintessence of a 
belief in the modifiability of the germ plasm. 
We see that even at that dawn of history 
this doctrine, familiar to us in the works 
of Hippocrates and of Aristotle, was original 

17 Fairbanks, Arthur, "The first Philosophers of 
Greece," New York: Charles Scribners' Sons, 1898. 



with neither. We may easily go back of 
Empedocles, who so influenced them both 
and who said: "it is not the difference in 
the vines that makes the wine good or bad, 
but in the soil which nourishes them. 18 In 
the views of Empedocles, not only the nour- 
ishment of plants but perception of animals 
by the senses is effected by the attrac- 
tion of kindred elements through their pores 
from the earth in which they grow and by 
the environment from objects of sensory 
emanations. These emanations are them- 
selves an idea of primitive man. In another 
essay 19 I have drawn attention to the con- 
ception of the Australian savage and of 
other men scarcely less primitive who 
conceive of the soul as emitting emanations 
from its tenement in the body of a magician 
which may be blown by the winds into the 
patient. They pass unseen through the 
pores of the witch doctor into those of his 
patient who sits in his lee. The conception 
of the soul which leaves the body tem- 
porarily often existed in the primitive mind 
in a sense similar to our demonstration of 
radial matter. The emanations of the soul 
of the savage may be considered the pro- 
totype of the sense emanations of Emped- 
ocles. Many primitive men have this con- 
ception of the radial energy of the human 
soul, and it is not at all difficult to follow 
traces of it into the science and the philo- 
sophy and especially into the religions of 
the modern world. 

As to the senses Empedocles supposed 
that the percepts of the mind arrive there 
through the sense organs by pores which 
admit the emanations from objects vis- 
ualized or noises heard, or odors smelt, 
savors tasted, surfaces touched. Of specific 
kinds these emanation atoms are recognized 
by like specific kinds within the organization 

18 Burrows, Ronald M., " Discoveries in Crete," 
New York: E. P. Dutton, 1907. 

19 Wright, Jonathan, "Blood and the Soul." 
N. York M. J., July 20, Aug. 10, Aug. 17, 
1918. 



130 



Annals of Medical History 



of the percepient by the soul. Em- 
pedocles was the great homoeopathist. Out 
of this form which homoeopathic or sympa- 
thetic magic took in the doctrines of AIc- 
maeon and Empedocles and Aristotle and 
the followers of the latter for two thousand 
years sprang the firm conviction of mankind 
in the inheritance of acquired characters. 
Like attracts like and like begets like. The 
idea is inherent in the magic of primitive 
man so prominently that ethnologists epito- 
mize its manifestations under the heading 
of homoeopathic magic. Neither primitive 
man nor Empedocles nor Hippocrates nor 
Aristotle nor their followers up to the middle 
of the nineteenth century ever had any 
other thought than that the race of men 
or the race of plants was governed in the 
manifestations of its heredity by the en- 
vironment in which its ancestors have 
been placed. The whole order of the thought 
of mankind was indeed, until very recent 
times, pantheistic, an order in which kindred 
enamations of a universal spirit pervaded 
all nature and modified one another both 
somatically and in their heredity. The idea 
that there was something in nature not 
affected by its environment, spirit or body, 
soul or matter, at once placed it in a new 
category of mysticism, essentially modern. 

The old order of thought is plainly mani- 
fested in the conceptions of a larger and 
larger class of cosmic phenomena, the 
further back we go in tracing the history 
of thought. As knowledge has advanced, 
one thing after another has emerged from 
the realm of mysticism and taken its place 
in the domain ruled by natural law. Em- 
pedocles and Aristotle thought their expla- 
nation placed heredity there, inefficient as 
it is in the ultimate analysis, but it remained 
for the nineteenth century biologists to 
place it back again in a new realm of mys- 
ticism by separating germ plasm from all 
other cosmic phenomena. It is the only 
thing which, we are now asked to believe, 
is unaffected by any of the rays of the 



environment Empedocles had in mind when 
he postulated his theory of the rays, which 
we have identified in chemistry, in physics 
and in biology. The forces of nature, as 
open to the observation of the savage and 
of Hippocratic Greek as to our own, we are 
assured have no influence on the germ plasm 
or on the units into which it is being sub- 
divided. 

I am eluding all responsibility for the 
truth or the error of such a conception. 
AH I mean to say is that, although this 
basis lies outside of the reasoning powers 
of man so far as they attempt to conceive 
of a material object unaffected by the 
proximity of another material object, it 
is a perfectly practical one upon which to 
rest certain phenomena in biological classi- 
fication, which is always a provisional and 
temporary adjustment. It is practical and 
of value because it allows biologists to 
separate them into two categories: — one in 
which no proof exists that environmental 
influences have any effect — one in which 
such proof does exist. There has been a 
ceaseless shifting from the first to the 
second category since this basis was adopted 
by an influential school in biology, and this 
capability to provide for future results attests 
its practical value. Anything that is clearly 
shown by evidence to be modified in its 
potentiality is not germ plasm. As soon as 
certain transmitted characters are shown 
to be changed, then the hypothetical units 
of the germ plasm on which they depend 
must be removed from the terms of the 
general hypothesis. Simply because a person 
might differ from his grandfather, owing to 
his father's having lived in a different 
climate, has not until comparatively recent 
times seemed sufficient reason for removing 
the phenomenon from any dependence on 
the true germ plasm. 

It was about twenty-four hundred years 
after the death of the author of "Airs, 
Waters and Places" that such an idea found 
lodgings in the brain of man. Unnoticed by 



Modern Commentaries on Hippocrates 



131 



its advocates, so far as I have observed, 
it takes its place alongside of the eternal 
and unchanging things whose existence we 
are forced to acknowledge but of which we 
can have no conception. If it is a reality, 
we must accept it as we must the actuality 
of time and space, something lying outside 
of every possibility of reasoning by analogy. 
Though Weismann himself finally recoiled 
before this logical deduction, it is not 
necessary here to decide whether we are 
as yet really driven to this desperate refuge 
or not. It is entirely sufficient here to draw 
attention to a possible reason why Hippoc- 
rates introduced, as such important factors 
in the etiology of disease, the environment 
of the air we breathe, the water we drink 
and the localities we inhabit, things which 
modern medicine for the most part seems 
to ignore — which we actually do ignore in 
our nosology. It was the absence of this 
miracle of the nineteenth century germ 
plasm, this unthinkable formula from the 
thoughts of men. 

He had an added incentive for doing so. 
He believed they influenced not only the 
mortal body of man, but his soul and his 
heredity. When they enter into our con- 
sideration it is in the course of an enthu- 
siasm for the therapeutical value of sunlight 
and fresh air in their effects on the tubercle 
bacillus, supposed to be wholly made up 
germ plasm, in the course of our observa- 
tion of the effect of heat and moisture on 
various protozoal agents of disease whose 
albuminoids are, I infer, not wholly germ 
plasm, or in the course of dietetic studies 
which convince us that in certain localities 
the human organism assimilates, less readily 
than elsewhere, food of high caloric value. 

In a historical essay, such as this pretends 
to be, I can thus enter into the modern 
biological argument only far enough to 
suggest it as one very important reason 
why Hippocrates seems to have exaggerated 
and why we very likely underrate the fac- 
tors of air, water and localities in our 



classification of disease etiology. Granting 
that this is an important reason, we may 
understand why the older commentators 
assumed a more sympathetic attitude 
toward this part of Hippocratic doctrine, 
and why, as we approach the era of Darwin, 
it recedes from discussion; notwithstanding 
the fact, entirely obvious to the quick 
perception of the student of modern medi- 
cine, that I am making the very scantiest 
allusion possible to other fields of modern 
research, very much affected indeed by 
considerations of airs, waters and localities. 
We cannot fail to realize, that, lately, in a 
historical sense, the advent of Darwinian 
doctrine and its further development in 
biology has radically changed our views 
of the effect of environment on disease. 
We have our ways of studying its connec- 
tion with disease which differ from those 
of Hippocrates, and it will be interesting, 
biologically as well as historically, to take 
note of this difference. 

It will not be entirely devoid of historical 
interest, at least, to see how Hippocrates 
made these factors influence not only the 
diseases of man, but, as I have fore- 
shadowed, the nature of man itself. Of late 
years there have been undercurrents of 
opinion among ethnologists which deprecate 
extreme notions as to the racial differences 
of men, which to some extent are identifiable 
with ideas of stable elements in the human 
germ plasm in the conception of the biolo- 
gist. 

The idea seems to be that there is in 
reality one race of men whose somatic 
attributes are modifiable by the environ- 
ment, climatic, as well as social and intellec- 
tual, but on the whole, this once eliminated, 
mankind is all much alike, especially from 
a point of view of brain capacity. I do not 
know that Hippocrates discusses the latter 
at all aside from his view, which agrees 
largely in fundamentals with this order of 
thought among ethnologists, but ^ differs 
radically from that of the Weismannian or 



132 



Annals of Medical History 



ultra Darwinian theory. So far as the prin- 
ciple is concerned, he made no discrimina- 
tion between the effects of the environment 
on the body and on the soul of man, on his 
mortal and his immortal part, on his soma 
and on his germ plasm, if you will, for I 
know of no other class than that of the soul, 
in Hippocrates' conceptions, in which to 
place the germ plasm. In reality as I have 
sufficiently insisted, it is something new, 
a third order of mental concept, partaking 
of the body in its manifestation and of the 
soul in its immortal nature, if we are to 
speak of the germ plasm in terms of the 
Hippocratic philosophy. I shall speak only 
of malaria here in its relation to the attitude 
he evinces towards the question which has 
for fifty years interested modern biologists. 

MALARIA 

Hippocrates emphasizes the differences 
which he declares exist between inhabitants 
of Asia and Europe. He says the environ- 
ment of one continent had made the people 
quarrelsome, assertive, independent, brave, 
and the environment of the other across 
the narrow seas had rendered them mild, 
temperate, indolent, soft and cowardly. 
He does not develop his argument far in 
explanation of this, but his critics have, it 
seems to me, missed the only indication 
he gives of how he explained to himself 
the manner in which this change comes 
about. He recognizes that the warlike and 
the courageous themselves will be changed 
by the institutions under which they live. 

No one will dispute his assertion that it 
is the change from the mean of climate that 
stimulates the physical and intellectual 
energies of men to activity. When, through 
the influence of an equable climate of a high 
temperature, those subjected to it have 
fallen under the sway of political institutions 
such as the ancient oriental monarchies, 
it becomes obvious to the dullest that their 
bravery, their vigor and their self denial are 
called into play for the exclusive benefit of 



those invested with the supreme power. 
Into this order of thought we must intro- 
duce modifications. We know that Asiatics 
may be brave men and, even if they are 
not capable of sustained vigor of mind, they 
often exhibit a contempt of life and a readi- 
ness to die, equal, at least, to anything Hip- 
pocrates had observed among the victorious 
Greeks of his day. He had not seen Asiatics 
or Africans fired with the visions of Para- 
dise. If the religions of Christ, of Moham- 
med and of the Mahdi had been phe- 
nomena of his day, raised up to counter- 
balance the pains of this life, he would 
have realized that there are other insti- 
tutions, besides the political organizations 
of freedom, which are quite as capable of 
stimulating the furious valor of countless 
millions of men. But he knew only those 
political and social institutions which could 
do this and which make life worth while 
to free men. He did right in recognizing, as 
did Xenophon and many others, that it 
was the intellectual and political freedom 
of their cities which made men ready to die 
for the glories of Greece. Fanaticism, which, 
as we have known it in the annals of history 
for two thousand years, also makes men 
quite as ready to die, was a closed book to 
him. Devotion to a local god or to the 
heterogeneous assortment on Olympus was 
not calculated to inspire men with the 
maddened desperation to which the Prophet 
spurred on his Arabians, panting for the 
sensual joys of Allah, or with the valor 
which strove for the beatitude kept un- 
der the keys of Rome, and which carried 
the cross as well as the crescent through 
the blood of a thousand fields of battle 
both in Asia and in Europe. 

These are phenomena, knowledge con- 
cerning which the world has garnered from 
the annals of history and stored up as the 
wisdom of ages since the days of Hippoc- 
rates; but he knew the political causes of 
cowardice and lethargy in men as well as 
we. The phenomena of fanaticism and faith 



Modern Commentaries on Hippocrates 



133 



are "institutions," which change cowardice 
into courage, but they were not the insti- 
tutions Hippocrates had in mind. He had 
in mind the political institutions and the 
ideals, inherited from brave ancestors, for 
which men have just died on the battlefields 
of Europe. So far, then, as he seems to have 
had some sort of hereditary influence in mind, 
affecting the nature of man, it was a social 
heredity; a kind of heredity we recognize 
in which, at least, the modern germ plasm 
plays a secondary, and the environment a 
primary role. I fancy none of us, neither the 
modern Lamarckian nor the Weismannian, 
would claim that such environment as works 
through social and political institutions 
upon the social and moral impulses of men 
has any effect upon the physical nature of 
man, but this confusion of social heredity 
with biological heredity often unconsciously 
invades the sense of modern discourses on 
the biology of man and his institutions. 

The analogy to biology has always been 
pushed to ridiculous limits by the sociolo- 
gists. It is likely to lead them far astray in 
theory, whether the biological theory is 
right or wrong, but it can hardly fail to 
do so when the model they pattern after 
is itself wrong. In practice "the survival 
of the fittest" has been the shibboleth in 
the present politico-social convulsion which 
has brought death and innumerable woes 
to many. If the unwary of today are be- 
trayed into these lapses of logic and on the 
other hand apply to biological phenomena, 
including social phenomena, a charge to 
which Herbert Spencer himself was open, 
we can hardly expect such analytical dis- 
crimination could have been appreciated 
by the immediate successors of the Nature 
Philosophers of 2,500 years ago. However, I 
think it can be perceived from the text 
that Hippocrates was not entirely oblivious 
to the differentiation which today is im- 
perative. In this analysis, revealed only 
by the introduction of his reference to 
institutions, there is of course no conception 



of the intermediaries through which his 
airs, waters and places work in producing 
disease. He perceived, perhaps, that it 
was through "institutions" that the climate 
worked upon the nature of men, but he had 
no inkling that there were different inter- 
mediaries through which the climate worked 
to cause the diseases of men. He traced to 
climate and locality, as causes, the phenom- 
ena of the moral nature of man, and he 
was instinctively right in reasoning by 
analogy that they were also often the causes 
of his diseases. The sickliness, the jaundice, 
the "quartan fevers," the lack of bodily 
and mental vigor, he was right in bringing 
into relation with the winds, the waters 
and the sun exposure. This time there was 
no "institution" to interpose as a direct 
influence, but there was an institution — a 
micro-organism of which he knew nothing 
but the results. It was hidden from him 
just as the fanaticism, from which the 
Greek world was free, was hidden from him. 
One of the factors influencing the moral 
nature of man and one of the factors 
influencing the bodily nature of man were 
alike absent from his field of observation. 
It is not directly the sun's heat, nor the fog 
and moisture of the marsh lands, it is not 
the failure of the breezes which parch up 
the veins of the sons of men who dwell 
there or relax the flesh of their bodies and 
change the color of their skins to a yellow 
hue. (However, these are the elements in 
the environment which call into existence 
the two links we have discovered during 
the last generation in the chain of causation.) 
It is the anopheles fasciata, it is the Plas- 
modium which it carries that stands between 
the factors with which Hippocrates and, 
Littre and Adams were familiar — airs, waters 
and places — and ague. It is the parasite of 
Laveran which alters the blood their fathers 
have transmitted to them, not the forces 
of nature which have altered the heredity 
of men. 

It is quite impossible to know what type 



134 



Annals oj Medical History 



of malarial poison infested the shores of 
Greece 20 and Asia Minor 2,500 years ago. 
Nothing is more improbable than that they 
were always afflicted by the same forms with 
which we are familiar, or that malaria in 
any form was constant in any one locality, 
or that the malignity of the type was such 
as now fills the army hospitals at Salonica, 
but the evidence is indubitable that in the 
Greece of Hippocrates, in some of the 
islands of the yEgean and on the littoral of 
Asia Minor — perhaps sometimes in one 
place, sometimes in another, varying from 
generation to generation, certainly from 
season to season — malaria was behind much 
of the confused picture of disease we find 
in the Hippocratic writings. 

I see no evidence that such affections have 
ever permanently affected the course of 
empire, though it is always impossible to 
say what might have been the course of 
events if anyone of the innumerable cosmic 
factors which have shaped history in the 
abyss of time had been absent. We may be 
disposed to deprecate the importance of 
the factor of malaria, but it is impossible 
to ignore the fact that disease has often 
in specific instances halted the march of 
armies on the road to conquest and raised 
the siege of cities. It is not impossible that 
in the past, as at present, in some of the 
districts of central Africa, and in some of 
the mediaeval cities, epidemics may have 
desolated lands and somewhat altered per- 
manently the course of human events; 
but for the most part the evidence in regard 
to the permanent influence of disease on 
empires and civilizations is dubious. Yet 
Hippocrates was dealing with this very 
problem when he noted the effect which airs, 
waters and localities had on the nature of 
man. The factors of this problem are not 
entirely clear in the light modern science 
has thrown on them, but they are dark in- 
deed, and but a tangled skein of thread, 

20 Jones, W. H. S., "Malaria and Greek History." 
Manchester: University Press, 1909. 



as we gaze on them in the writings of 
Hippocrates, through the dimness of more 
than two thousand years. In the "Epidem- 
ics," we perceive easily, after reading 
Littre's masterly analysis of the first and 
third books, that the severest types of 
malarial fever prevailed on the mainland 
and the islands which fringed the shores 
of Greece and Asia Minor in the days of 
Hippocrates. We take note of the fact that 
he confused to some extent, as do modern 
biologists and ethnologists, the effect of 
"institutions" on men, and the effects of 
the malarial poison working through the 
lassitude of their bodies on their moral 
natures. 

Many critics have noticed in Hippocrates 
the absence of any indication which they can 
plainly recognize of his appreciation of 
the infective nature of fevers arising from 
proximity to the stagnant waters of many 
of the Greek rivers and swamps. I think this 
can hardly be laid at the door of antiquity 
with justice since even in Hippocrates we 
find reference to the influence of locality 
on the type of disease in such connection 
that it can scarcely be doubted that he was 
familiar with pestilential varieties of swamp 
fever even if he did miss the plasmodium 
malariae and took no note of the anopheles 
jasciata. In this book we should not fail 
to notice in this connection his remark that: 

Such cities as lie well to the sun and winds, 
and use good waters, feel these changes less, 
but such as use marshy and pooly waters, and 
lie well both as regards the winds and the sun, 
these all feel them more. And if the summer be 
dry, those diseases soon cease, but if rainy, they 
are protracted. 

It is interesting in this connection to read 
what Diogenes Laertius says of the wonders 
wrought by Empedocles. I give it as trans- 
lated by Yonge. 21 

21 Diogenes Laertius, "Lives and Opinions of 
Eminent Philosophers," tr. by C. D. Yonge. London: 
Henry G. Bohn, 1853. 



Modern Commentaries on Hippocrates 



135 



XI . . . When a pestilence attacked the 
people of Selinus, by reason of the bad smells 
arising from the adjacent river, so that the men 
died and the women bore dead children, Emped- 
ocles contrived a plan, and brought into the 
same channel two other rivers at his own ex- 
pense; and so, by mixing their waters with 
that of the other river, he sweetened the 
stream. And as the pestilence was removed 
in this way, when the people of Selinus were 
on one occasion holding a festival on the bank 
of the river, Empedocles appeared among them; 
and they rising up, offered him adoration, and 
prayed to him as to a God: And he, wishing to 
confirm this idea which they had adopted of 
him, leaped into the fire. 

It is very evident that to Alcmaeon and 
to Empedocles the Hippocratic collection 
owes much of its physiology and anatomy; 
perhaps to the former a whole treatise, and 
it is improbable in the extreme that Hippoc- 
rates himself was not familiar with the 
influence of swamp land on the production 
of certain types of fever. Reference is made 
to those that accompany the prevalence of 
winds from marshy places in the second 
book on "The Diet" (38), but no classifica- 
tion or comprehension of them based on 
etiology can be found, conforming to the 
nosology which has resulted from the dis- 
covery of the plasmodium and its carrier, 
until well within the experience of living 
men. The comments of Adams and of Littre 
are scarcely less confusing to the recent grad- 
uate than those of Hippocrates. Indeed, 
in a way, Hippocrates and his immediate 
predecessors were more alive to all the 
factors entering into the etiology of malaria 
than were these gentlemen of the middle 
decades of the last century. As for us the 
Plasmodium and the anopheles have all but 
eliminated from our thoughts the environ- 
ment which makes their existence possible. 
For us a chain hangs down out of the sky 
and we only keep constantly in our visual 
focus these two links. What is the Plas- 
modium to us but for the anopheles? What 



would become of the anopheles, but for the 
swamp and and the heat, and so on ad 
infinitum. The literature which has grown 
up around the plasmodium and its carrier 
serves to alienate the mind, especially the 
mind uninstructed in the history of the 
medical art, from an attitude toward the 
intermittent and continued fevers with 
which Littre and his contemporaries two 
generations ago were familiar, and Hippoc- 
rates quite as intimately two thousand 
years ago and more, though the evidence 
of it is more convincing elsewhere than in 
this book on the "Airs, Waters and Places." 
In addition to the incidental interest 
to be noted in an account of early attempts 
to eradicate malaria, and in the reference 
I have made to early evolutionary doctrine, 
I have especially striven in the foregoing 
to show how intimately in the thought of 
Hippocrates was combined the influence 
of the same environment on the corporeal 
and on the spiritual nature of man as well 
as on his social and political relations. 
This catholicity of thought is entirely 
foreign to our modern medical mentality 
and I cannot urge with too much emphasis 
that we are thereby the losers. It is that 
broadening of medical thought which should 
be the concern of all education, but it is 
nowhere so lacking in the liberal professions 
as in the curriculum of the student of medi- 
cine. Incoherent as it may appear to the 
modern reader in the Hippocratic text, 
which I fear I have not made much more 
coherent in the foregoing, such defects must 
be charged to the reader and to the expositor 
rather than to the author, to whom, obvi- 
ously, there was no gap in the consecutive- 
ness of the reasoning in his apprehension 
of the cosmic laws applying to the spiritual 
and the physical phenomena of human 
beings. To him, indeed, as to Terence, 
nothing which was of human interest was 
foreign. 



THE RISE AND EARLY HISTORY OF CLINICAL TEACHING 



By DAVID RIESMAN, M.D. 



PHILADELPHIA, PA. 



THE history of medicine is in a 
sense the history of civilization. 
Among a given people, ancient 
or modern, the state of medicine 
is as much an index of its culture as are its 
art and its literature. The world is, how- 
ever, too busy to study medical history in 
order to find out what level a nation has 
attained at any particular time. This applies 
not only to the non-medical world but also 
to medical men themselves. Only a few have 
an interest in the history of their calling; and 
yet nothing is more instructive or inspiring, 
whether viewed from the narrower stand- 
point of the physician or from the broader 
one of the student of the race, than is the 
development of medicine throughout the 
ages. At the present day the lay public knows 
a great deal about medicines, but very little 
about medicine. If the people knew more 
concerning it they would have a greater 
respect for what medicine has accomplished. 
From the vast and inexhaustible mine of 
the history of medicine I have extracted a 
single chapter, in itself large and fascinating, 
yet, strange as it may seem, few have written 
upon it. There are tomes upon tomes of 
medical history, some dealing with the doc- 
trines and practices in vogue at different 
epochs or periods — Hindoo, Greek, Egyp- 
tian, Arabic, Talmudic medicine, for ex- 
ample. Few, however, concern themselves 
with the history of medical teaching, with 
the ways in which the accumulated knowl- 
edge has been transmitted from generation 
to generation. It is a consideration of that 
phase of medical history that I have made 
my task in this essay. 

The medical students of to-day, who are 
virtually living in the wards of hospitals for 
the greater part of their last year in medicine, 
and in that way coming into direct personal 



contact with patients, cannot realize what 
the teaching of medicine was a few genera- 
tions ago. In my student days we saw only a 
few medical cases close at hand. Most of them 
were seen from the benches in the amphithea- 
tre and I do not think that we ever had an 
opportunity of making a complete physical 
examination of a single patient. Yet we 
were better off than the men who were our 
teachers ; and if we go back but a little far- 
ther, we come to a time when there were no 
clinical facilities whatever. J. Marion Sims 
was graduated in Philadelphia in 1835 an d 
immediately went to his home in South 
Carolina to practise. His sign, which was a 
very big one, had not been out long before 
he was called on to treat a child of the 
leading citizen of the town. He had never 
until then been in contact with a patient 
and had never made a physical examination. 
In consequence, he felt himself helpless, 
and when the child died he was profoundly 
depressed. Then when a second child in the 
same family died shortly afterward under 
his ministrations, he quietly took down 
his sign, dropped it into a well, and mi- 
grated to Alabama. Fortunately for Ameri- 
can surgery he did not carry out his in- 
tention of giving up the practice of medicine 
for good. 

The first teacher of medicine was neces- 
sity. When primitive man received a wound 
during the chase or in combat, another 
member of his tribe or of his family applied 
soothing herbs, the virtues of which he 
knew as the result of some happy accident. 
After having obtained success with this 
treatment, he would initiate his son or some 
one else into the secret of the preparation 
and use of the soothing lotion. Thus arose 
surgery. In the case of internal diseases, 
and especially those of epidemic character, 
136 



The Rise and Early History of Clinical Teaching 



137 



the causes of which were to him unfathom- 
able and mysterious, man sought the help 
of his gods and naturally applied to those 
who knew the wishes of the gods, the priests. 
These tried to appease the wrathful deity 
with prayers and incantations — a survival 
of which we see to-day in public prayers for 
the sick. The priests were always the ablest 
and shrewdest men in the community and 
by experience through the ages gained con- 
siderable practical knowledge in the treat- 
ment of disease. In that way there came 
to be added to the religious ceremonies 
methods of therapy of more or less value. 
The religious practices and therapeutic 
methods were handed down in the priestly 
castes by oral tradition. 

Among the Greeks, however, the priest- 
hood never had a very strong influence; and 
the practice of medicine was rather a secret 
in certain families or social groups. The 
first teacher of medicine among the Greeks 
was the legendary Esculapius, who taught 
his son Machaon to bind up the wounds of 
the Trojan warriors, and his other son, 
Podalirius, to attend to their internal ills. 

Eventually the common experience of the 
medical families was written down; and a 
study of the written works was added to 
oral tradition. The actual teaching was 
carried out in the so-called iatria, which 
may be compared to our out-patient de- 
partments or dispensaries, and which were 
usually built in close proximity to an Es- 
culapian temple. In the iatria, the physician 
received and examined the patients, pre- 
scribed and distributed medicines, per- 
formed surgical operations and gave instruc- 
tion to pupils. The most famous iatria or 
schools, were those of Cnidos and of Cos. 
The latter was the birth place of Hippo- 
crates, under whom, at about 400 B.C., 
Greek medicine reached its zenith. As 
teachers of medicine Hippocrates and his 
contemporaries, for the most part unknown 
to us, were not excelled for a thousand 
years; indeed, for nearly two thousand. 

Hippocrates was a wonderful observer 



and impressed upon his disciples the im- 
portance of bedside observation. In a 
sense, physical diagnosis originated with 
him; for he discovered the succussion splash, 
pleural friction and pulmonary rales. He 
advised that in order to hear these sounds 
the ear be laid upon the chest for a con- 
siderable length of time. This is the earliest 
mention of auscultation. The Hippocratic 
School also tested the temperature of 
the body with the hand, and by palpation 
determined the boundaries of the liver and 
spleen. It is scarcely believable, and yet it 
is a fact, that fifteen hundred years later 
these simple but valuable physical methods 
were thought to be of no importance and 
were scarcely taught anywhere. 

After Alexander the Great's time, Alex- 
andria became the center of Greek life and 
medical teaching. Under Herophilus and 
Erasistratus, the Alexandrian School at- 
tained great fame, so that it was a distinc- 
tion to any physician to be able to say that 
he had studied at Alexandria. 

Among the Egyptians, from whom the 
Greeks undoubtedly derived some of their 
knowledge, medicine was in the hands of 
the priests, who controlled all the learned 
occupations. The foundations of instruction 
were the Holy Books in which all Egyptian 
knowledge was contained. These books 
were an encyclopedic work of forty-two 
parts, of which the last six were devoted 
to medicine. The first of these treated of 
anatomy; the second, of diseases; the third, 
of surgery; the fourth, of drugs; the fifth, 
of diseases of the eye; and the sixth, of 
diseases of women. Only fragments have 
come down to us. They are contained in the 
"Book of the Dead," and in the "Ebers 
Papyrus." There are medical allusions in 
the cuneiform inscriptions of the Babylon- 
ians and the Assyrians; but in so far as they 
have been deciphered, they tell us little 
about the teaching of medicine, and are 
chiefly formulas or, as in the Code of Ham- 
murabi, tables of fees and penalties. 

Among the Hindoos, the teaching of 



i 3 8 



Annals oj Medical History 



medicine early reached a high plane; and 
the Yajur Veda, in the Commentaries of 
Charaka and Susruta, contains explicit in- 
structions as to the education of the physi- 
cian. Susruta recommends to the student 
of medicine both theoretical and practical 
training. "He who is only theoretically edu- 
cated," says Susruta, "and is inexperienced 
in the details of practical treatment, does not 
know what he should do when he receives a 
patient, and conducts himself as foolishly as 
a coward on the battle-field. On the other 
hand, a physician who is educated prac- 
tically and not theoretically lacks the 
esteem of better men." This reminds one 
of the dictum of Osier, "to study the phe- 
nomena of disease without books is to sail 
on an uncharted sea, while to study books 
without patients is not to go to sea at all." 
The Hindoo teacher was therefore advised to 
instruct his pupils in the use of salves and 
remedies, in the performance of surgical 
operations and in general medical practice, 
"since through hearing lectures no one can 
become proficient in the medical calling." 
Susruta taught that the sweet taste of urine 
was a sign of disease. He advised that a 
thorough history be taken of every patient, 
saying that the patient should be asked 
where he lives, the season of the year in 
which his trouble arose, his position, his 
affairs, the nature of his pain, his general 
strength, appetite, and the duration of his 
illness. Operations were taught on inani- 
mate objects. No physician was allowed to 
have more than five or six pupils. 

Hospitals existed in India not alone for 
human beings, but even for animals as early 
as 300 B.C. (There is one known to have 
existed on the island of Ceylon in the fifth 
century B.C.) In view of the fact that the 
study of anatomy was totally neglected it 
is remarkable that Indian medicine was 
able to reach such a high plane. This is 
one of the riddles of medical history. 

Among the Romans, medicine was on a 
much lower level than among the Greeks. 
Sacrifices, magic formulas and oracles were 



supposed to cure disease. A few curative 
herbs were employed. As stated by Seneca: 
"Medicina quondam paucarum fuit scientia 
"herbarum quibus sisteretur fluens sanguis, 
vulnera coirent" (Medicine was the science 
of a few herbs by means of which the flowing 
blood was staunched and wounds were 
united. Epis. 95). 

Under Greek influence, a higher type of 
medical practice gradually came into vogue; 
yet medicine was for a long time looked 
upon as a despised trade. The Roman 
nobles had it taught to their slaves ; or some- 
times, as in the case of M. Portius Cato, 
they acquired it themselves in order that 
they might teach it to their slaves and keep 
a watch over the health of their own 
families. But with the tremendous political 
and social development of imperial Rome, 
medicine could not long remain patriarchal. 
Probably the constant foreign wars, re- 
quiring the services of skilled physicians, 
helped to bring about the downfall of the 
patriarchal system. For a long time, how- 
ever, medicine remained a private matter 
or a free trade that could be followed by 
anyone. Under Alexander Severus, special 
auditoriums were assigned to medical teach- 
ers, in return for which they had to instruct 
poor students free of charge. It is probable 
that the valetudinaria which rich Romans 
established for their slaves were used for 
medical instruction. That this instruction 
had a decidedly modern aspect is shown in a 
sort of novel by Philostratus, in which 
mention is made of two physicians who 
visited the sick accompanied by thirty 
pupils. Such visits were made in large con- 
sultation rooms, called tabernse medicinee, 
or simply medicinae. As a further evidence 
that clinical teaching similar to our ward 
visits existed, we have the famous lines of 
Martial (Epigr. V. 9) : 

Languebam, sed tu comitatus protinus ad me 
Venisti centum, Syramache, discipulis, 
Centum me tetigere manus aquilone gelatse, 
Nee habui febrem; Symmache, nunc habeo. 



The Rise and Early History of Clinical Teaching 



139 



I'm out of sorts, but Symmachus is here, 
His hundred pupils following in the rear; 
All feel my pulse with hands as cold as snow, 
I had no fever then — I have it now. 

After the fall of the Roman Empire we 
find the teaching of medicine conducted like 
the apprenticeship of a trade. A youth who 
wanted to become a physician would attach 
himself to a friendly practitioner, much as 
in the preceptorial system. This arrange- 
ment in a modified form lasted until about 
twenty-five years ago. 

With the spread of Christianity and the 
establishment of hospitals by the ecclesiasti- 
cal orders, medical practice, to a large extent 
fell again into the hands of the priests, par- 
ticularly the Benedictines who according to 
Puccinotti were the first in the Middle Ages 
to give clinical and didactic instruction. 
It seems also that in the time of Charle- 
magne, 764-814, the teaching of medicine 
received some attention at his court; few 
data, however, have come down to us 
regarding this school. 

When celibacy became a law among 
ecclesiastics, priests were forbidden to prac- 
tice surgery and to treat diseases of women. 1 

Among the Arabs at this time, medicine 
was at a very high level. They had hospi- 
tals with vast numbers of students, who 
were instructed both practically and theo- 
retically. There were hospitals at Damascus, 
Bagdad, Cairo, and probably elsewhere in 
Europe and Northern Africa, wherever the 
Saracens had gained a strong foothold. Yet 
progress under the Arabs was not so great 
as it might have been, despite clinical teach- 
ing in the hospitals, for the reasbn that dis- 
section was indirectly forbidden by the tenets 
of the Koran, a corpse being "unclean." 

1 It appears that for a time celibacy was enforced 
among physicians also. At any rate, in 1452, Cardinal 
d'Estouteville, charged by Pope Nicholas V. with 
the reorganization of the University of Paris, ob- 
tained the suppression of celibacy "as an impious 
and unreasonable thing for a doctor." (Supoy, "Le 
moyen age medicale," p. 27). 



The first real progress in medical teaching 
after this time is coincident with the rise 
of the great University of Salerno, the 
origin of which is shrouded in obscurity, 
although, according to some of the Italian 
historians (as for example, Puccinotti: 
"Storia della medicina," vol. 11, part 1, 
p. 247, "La Scuola detta Salernitane e bene- 
dettina e Cassinense di origine"), it is the 
offspring of the Benedictine monastery of 
Monte Cassino. 2 Since Charlemagne is known 
to have been interested in it (Ravon: "La 
France medicale," 1902, p. 409), its origin 
certainly dates back to the eighth century. 
Its medical faculty was composed of Greek, 
Italian, Jewish, and Arabic physicians, so 
that almost anyone could there study medi- 
cine in his own language. It was unusually 
free from ecclesiastical influence; the 
professors were married. Strange as it may 
seem, some of the lectureships were held by 
women, usually the wives or daughters of 
professors. Abella wrote: "De atro bilo 
et de natura seminis humani"; another, the 
famous Trotula, published a work on dis- 
eases of women entitled, "De mulierum pas- 
sionibus ante, in et post partum"; and Re- 
becca, one on fevers, urines and the embryo. 

The school received a great impetus 
through the Crusades, and many a wounded 
and sick Crusader as, for example, Robert 
of Normandy, son of William the Con- 
queror, was treated there. Clinical instruc- 
tion must have been carried out at Salerno, 
although details are meagre. We do know, 
however, that special attention was paid 
to dietetics. Under the great emperor 
Frederick II, in versatility and in ruthless- 
ness not unlike the last of the Hohenzol- 
Ierns and like him of Swabian blood, the 
medical school at Salerno in 12 13 grew 
into a complete university. It is a fact 

2 Daremberg (" Histoire des Sciences Medicales," 
Tome I, p. 259) denies that the medical school of 
Salerno originated from the Benedictines, the Arabs, 
or the Jews, and holds that it is Neo-Latin or Greco- 
Latin in origin. 



140 



Annals of Medical History 



worthy of note that the two great Conti- 
nental universities of the Middle Ages, 
Salerno and Montpellier, arose out of med- 
ical schools. Frederick also gave to the 
Salernitan school an excellent code of laws 
and a curriculum. Three years had to be 
devoted to philosophy, and five to medi- 
cine, with examinations at the end. 
Just as in Pennsylvania at the present time, 
this university examination did not per se 
confer the right to practice; the young 
physician had to associate himself for one 
year with an older practitioner — a custom 
similar to our hospital year. 

I have just spoken of Montpellier, which 
is of particular interest to us, as the great 
Sydenham studied there. Montpellier was 
founded under the influence of the Saracens, 
who came from neighboring Spain. In 
1 137, the medical school had its own build- 
ing. Its fame really begins with the advent 
of Solomon Matthseus from Salerno in the 
twelfth century. In 1220, Cardinal Conrad, 3 
a German, demanded that everyone who 
intended to teach there must pass an exami- 
nation. Pope Clement V, in 1308, estab- 
lished the rule that medical students must 
hear lectures for five years and during 
eight months, or two summers must attend 
a physician in medical practice. An intense 
rivalry existed between the University of 
Montpellier and the University of Paris. 
This rivalry was probably good for medical 
teaching; its bitterness is well illustrated in 
some of the Latin verses of Gilles de Corbeil, 

3 It may not be without interest to quote a statute 
of this Cardinal dated 1220 regarding the University 
of Montpellier. It is a medieval example of the black 
list: "If a professor is in litigation with one of his 
pupils with respect to his salary or for any other 
reason, no other professor shall knowingly receive 
this pupil until he has given or promised satisfaction 
to his former master." The same statute forbids 
sordid competition among the professors: "No 
teacher shall attract to himself the disciple of 
another teacher, in order to take him away, by 
solicitation, present or any other means whatso- 



the great medical teacher of Paris in the 
thirteenth century. (Vieillard: La France 
medicale, 1902, p. 397.) 

Under the corroding taint of scholas- 
ticism, both the University of Salerno and 
that of Montpellier rapidly deteriorated; the 
latter suffering eclipse through the growing 
fame of the University of Paris. In the 
seventeenth century, Montpellier experi- 
enced a temporary revival through the fame 
of Charles Barbeyrac (1629- 1699), called 
the Hippocrates of Languedoc, who is 
remembered as one of Sydenham's teachers. 

It seems that after the decline of the 
schools of Salerno and Montpellier, and at a 
time when learning in general was beginning 
to reanimate the world, in preparation for 
the coming of the Renaissance, medical 
teaching ebbed to almost the lowest possible 
point. Instruction degenerated into dia- 
lectical discussions and hairsplitting argu- 
ments based chiefly on the writings of 
Hippocrates and Galen. Even the great 
Rabelais was roused to wrath by the med- 
ical teaching of his day, which was "toute 
Iivresque." (Ledouble: La France med- 
icale, 1907, p. 207.) There is extant a 
program of lectures in medicine at the Uni- 
versity of Heidelberg for the year 1569. 
Professor Curio lectured on "De generibus 
morborum" of Galen, and explained "De 
morborum signis" of Hippocrates. Professor 
Erastus did not lecture, because he had 
gone to the fair in Frankfort. Professor 
Melancthon, a nephew of the great Pro- 
testant reformer, delivered lectures in medi- 
cine on the basis of Galen. Would not Hip- 
pocrates, who had taken his pupils to the 
bedside of his patients and had taught 
them physical signs and keen observation, 
have marveled at the fact that, twenty 
centuries after his time, such inane dis- 
courses should constitute the sole instruc- 
tion in medicine? Another hindrance to 
progress was the interdiction by the Church 
of dissection of the human body; and 
even after that was lifted, the obtaining of 



The Rise and Early History of Clinical Teaching 



141 



bodies for dissection was a difficult 
matter. 

It is interesting to learn through the 
researches of Sudhoff ("Studien zur Ge- 
schichte der Medizin," Heft. 8) how medical 
students were taught in the University of 
Leipzig during the first hundred years after 
its foundation in 1409. The lectures were 
given from six to seven o'clock in the morn- 
ing during the summer and from seven to 
eight during the winter. During the first 
and second semesters, the first canon of 
Avicenna, during the third and fourth the 
liber tegni of Galen, and during the fifth and 
sixth the aphorisms of Hippocrates, with 
commentaries by Galen, were explained. 
The course in "practical medicine," so- 
called, took place in the afternoon. The 
holder of the chair explained a book of 
Rhazes, the first chapter of the fourth book 
of Avicenna, and the fourth chapter of the 
first canon by the same author. The lec- 
tures were given in the church of St. Nicho- 
las. As for surgery and anatomy, they were 
completely neglected at Leipzig during the 
first century of this school's existence. 

At the University of Montpellier, which 
was already ancient when the University of 
Leipzig was established, teaching was car- 
ried out as follows: The lectures began at 
six o'clock in the morning and lasted one 
hour. They consisted of dictation or reading 
of Latin texts and making comments upon 
them. Dissections, inaugurated in 1376, did 
not take place more than once or twice a 
year and then the entire public was per- 
mitted to attend on paying an admission 
fee. There was absolutely no clinical teach- 
ing. The whole course occupied a total of 
about six months. At the end of this time 
the student in order to obtain his license 
had to practice six months outside of the 
city. If then he passed his examinations as 
a bachelor, the beadle clothed him with a 
red robe, while his comrades one by one 
administered a good blow with the fist. To 
obtain the doctorate he had to pass sixteen 



examinations. When his studies were finally 
completed, the new doctor had expended 
about sixteen thousand francs though after 
the year 1550 the cost was reduced to eighty- 
one hundred and fifty francs, still a formid- 
able sum (Paul Delmas, Bull, mensuel de 
I'Academie des sciences et lettres de Mont- 
pellier, March, 191 3, No. 3). 

Although hospitals were springing up all 
over Europe (in Germany, for instance, the 
Order of the Holy Ghost founded not less 
than 154), clinical instruction was not given 
in any of them. Not even in the great Hotel 
Dieu of Paris, founded in the eighth cen- 
tury, was any use made of its wealth of 
clinical material for nearly a thousand 
years. What practical experience the stu- 
dent got was obtained by his attaching 
himself to some obliging physician outside 
of the university, who acted as an extra- 
mural teacher and took him along on his 
rounds. This custom eventually led to the 
establishment of policlinics, apparently first 
at Montpellier. By "policlinic" is meant 
something quite different from that which 
the word polyclinic now connotes, namely, 
an organization for visiting patients in their 
homes in various parts of the city. Hence, 
the word poli-clinic (ir6Xts, city); the 
present term, "poly-clinic" (toKvs, many), 
being really a misnomer. One of the Mont- 
pellier physicians, Theophrastus Renau- 
dot, migrated to Paris, established a poli- 
clinic there, and became a protege of 
Richelieu and physician to Louis XIII. 
In the Rue de Calandre at the Sign of the 
Golden Cock he established a sort of dis- 
pensary for the poor. He incurred, however, 
the enmity of the faculty of the University 
of Paris — particularly of its brilliant but 
vindictive leader, Guy Patin 4 (1 601-1672), 
whose motto, "Saigner et senner" (Bleed- 
ing and senna) helped to make him famous. 

4 Guy Patin anathematized William Harvey and 
spoke of Harvey's discovery of the circulation of 
the blood as "paradoxical, unintelligible, absurd, 
and harmful to human life." 



142 



Annals of Medical History 



In consequence the dispensary did not 
last long; and yet it was practically the 
only attempt at clinical teaching in Paris 
for several centuries. It is almost incon- 
ceivable that the material of the Hotel 
Dieu, which at this time had a capacity 
of two thousand beds, was not used for 
medical instruction. The conditions in this 
famous hospital were very remarkable as 
we know from a graphic account written 
by a Saxon tailor, Christoph Rink. This 
man entered the hospital as a patient and 
was received by an old barber, who touched 
him in various places to determine the 
nature of his disease. A priest recorded 
his name in a book, and two assistants 
conducted him to his quarters, where 
he was placed in a large bed between two 
other patients, in such a way that his head 
lay between the feet of his bed-fellows. 
This sort of community of living was quite 
the rule in those days; and even in the 
eighteenth century, three, four and even five 
patients were often placed in a single bed. 
Frequently as many as four puerperal wo- 
men were put together. Both of Rink's bed- 
fellows died. The first treatment our Saxon 
tailor received was psychic, an attempt 
being made to persuade him to believe the 
right religious doctrine; but he was a 
staunch Lutheran and resisted. The fol- 
lowing day the doctor came, with the 
apothecary and the barber; and the tradi- 
tional bleeding began. Rink was bled not 
less than twenty times, and yet lived to 
tell his tale. For the nuns, who conducted 
the nursing in the hospital and of whom 
there were three hundred, he had only the 
highest praise. 

Moliere, in his inimitable comedy, "Le 
malade imaginaire," has drawn a true pic- 
ture of the time. The son, Thomas of Dia- 
foirus, comes up for his baccalaureate de- 
gree in medicine; and in his behalf the 
following statements are made: "He is firm 
in dispute, and strong like a Turk in his 
principles; and he never recedes from his 



opinion, but presses the argument to the 
last vantage point of logic; but, above 
everything else, that which pleases me," 
says his father, "and in which he follows 
my example, is that he is attached blindly 
to the opinions of the ancients, and that he 
will not comprehend nor hear the reasons 
and the experiences of the pretended dis- 
coverers of our times touching the circula- 
tion of the blood or any other opinion of 
equal stripe." To all questions as to the 
remedies to be used in the various diseases, 
Thomas invariably answers: 

Clysterium donare, 
Postea seignare, 
Ensuita purgare, 
Reseignare, repurgare 
Et reclysterisare — 

to which the chorus makes the following 
response: 

Bene, bene, bene, 

Bene respondere. 

Dignus est intrare 

In nostro corpore. 

In Rome, as late as the sixteenth century, 
in order to become a physician the medical 
student had to pass an examination on the 
physics of Aristotle and the doctrines of 
Galen. This was followed by a question in 
which one of the examiners described the 
symptoms of a disease and then asked the 
name and treatment. Having passed this 
test, the final act of initiation was the giving 
of a banquet to the examiners. 

About the middle of the sixteenth cen- 
tury, near the close of the Renaissance, 
Professor Dal Monte, 5 a friend of Vesalius, 

6 Dal Monte took an active part in the battle 
raging between the two camps into which the pro- 
fession was divided in his time on the matter of 
bleeding. The one upheld the Arabic method, accord- 
ing to which the bleeding was to be done at the 
point farthest removed from the disease focus; at 
the foot, for example, in pneumonia; the other prac- 
ticed the Hippocratic method, according to which 
the patient was to be bled from the arm corre- 
sponding to the side affected. Dal Monte and 
Vesalius were Hippocraticists. 



The Rise and Early History of Clinical Teaching 



143 



made the first modern attempt at clinical 
teaching, in the hospital of St. Francis at 
Padua. Little resulted from Dal Monte's 
efforts, but under his successors, Oddi and 
Bottoni, in about 1578, real bedside teaching 
began. Until quite recently I accepted it as 
a fact, having seen it in a number of works, 
that the first clinical teacher was Boerhaave; 
but Renaudot, Petersen, Puschmann and 
other reliable authors have clearly demon- 
strated that the credit for inaugurating clini- 
cal teaching belongs to these two otherwise 
unknown Italians, Oddi and Bottoni. Oddi 
gave his clinical lectures in the women's 
ward and Bottoni in the men's ward of 
St. Francis' Hospital. They illustrated their 
lectures with autopsy material. Autopsies 
were, however, still forbidden by the eccle- 
siastical authorities. Not long after Oddi 
and Bottoni, a blight struck the University 
of Padua, so that when the Dane, Thomas 
Bartolin, visited the city, he found only a 
"scola de pulsibus et urinis." Nevertheless, 
short as the period of clinical teaching was 
at Padua, it bore great fruit. The new 
idea was transplanted first to Holland, 
where Jan Van Heurne, who had studied at 
Padua, introduced it. His own success was 
slight; far greater was that of his son, Otto 
Van Heurne, who followed him in 1601. 
Somewhat later, in 1636, Wilhem Van Den 
Straten (1 593-1 681) established a remark- 
able clinic at Utrecht. He examined patients 
in the presence of a class of students, and 
discussed the diagnosis, prognosis and treat- 
ment with them. Following this, there was 
a public debate concerning the nature of 
the disease. 

Under Otto Van Heurne the students in 
Leyden visited the clinic two days a week, 
four students acting as clinical clerks, as 
we know from an extant letter of Thomas 
Bartolin. The authorities, however, in their 
wisdom, decided that this sort of teaching 
was not of much use and commanded the 
professors to instruct their students in the 
knowledge that can be gained from a study 



of the pulse and the urine. As most of the 
diseases were believed to have their seat in 
the blood, and as the urine was looked upon 
as a percolate of the blood, it seemed logical 
to determine the chemical composition of 
the latter by a study of the former. This 
rendered diagnosis extremely easy. As an 
illustration, I might cite what the monk 
Mercurius taught (at a somewhat earlier 
period, it is true) regarding the pulse: "If 
one lays four fingers of the right hand on 
the pulse of the right arm of the patient, 
one can conclude that the disease is in the 
head if the pulse is felt mainly by the 
index finger; that the disease is in the thorax 
if the middle finger feels it; and that it is 
in the abdomen if the fourth finger per- 
ceives the chief impact." One of the nota- 
ble Byzantine physicians, John Actuarius, 
distinguished fourteen colors of the urine, 
each one having a definite diagnostic mean- 
ing. 

In the days of Van Heurne, enemas were 
greatly in vogue, and much time was spent 
in instructing the students in their prepa- 
ration. 6 

Under the stimulus of the invention of 
the thermometer, the magnifying lens, the 
microscope, and above everything else, 
through the epoch-making discovery by 
William Harvey, of the circulation of the 
blood a spirit of rebellion arose against the 
authority of the ancients that had held medi- 
cine in bondage for so long. When a man 
appeared upon the scene who taught medi- 
cine at the bedside, students flocked to 

6 A famous enema of Van Heurne's had seventeen 
ingredients, for the mixing of which the most minute 
directions were given. I might also mention an- 
other famous preparation — the mystical theriacum — 
which had no less than seventy-two constituents, 
and was looked upon as the apothecary's master- 
piece. It is recorded that in 1754, in Nuremberg, 
the completion of this drug, which had required two 
months' labor under the supervision of the Senate, 
was celebrated with many civic festivities. Both 
Boerhaave and Van Swieten used theriacum, al- 
though the former's motto was simplex sigillum veri. 



i 4 4 



Annals of Medical History 



him from all parts of the world. This man 
was Boerhaave, called "Medicorum Univer- 
sx Europae Praeceptor," under whom the 
medical school of Leyden attained an 
extraordinary fame. As a teacher his influ- 
ence has probably never been equaled. The 
son of a clergyman, he was himself prepared 
for theology but preferred medicine. His 
teaching consisted in lectures and beside 
demonstrations in which he followed the 
cases through their course. His, to us, absurd 
theories of Jiuida and solida and of tem- 
peraments, are characteristic of his time, 
but could not endure when morbid anatomy 
in the epoch-making work of Morgagni 
(1682- 1 771) showed that disease had a 
local habitation. Boerhaave had a good deal 
of common sense and attributed many 
diseases either to poverty or to luxurious 
living, "nihil citius debilitat quam luxus." 
It does not appear that he made any autop- 
sies, being in this respect far behind his 
predecessor in the Leyden chair, the famous 
De La Boe, or Sylvius ( 1 6 1 4- 1 672) . Consider- 
ing that the seat of diseases was in the blood 
or the bile, he naturally could not appreciate 
the importance of local pathologic processes. 
The methods of the Leyden Clinic, which 
had only twelve beds, were carried to all 
parts of Continental Europe and by Pringle 
and others to England. In Edinburgh a 
number of men, directly or indirectly pupils 
of Boerhaave, established clinical teaching 
early in the eighteenth century. It appears 
that one Daniel Duncan inaugurated such 
teaching in 1720, but the first regular courses 
were given by Rutherford and afterwards 
by CuIIen, Gregory and Drummond. The 
last two were the first to teach in the 
English language, Latin having been used 
prior to that time. In the days of which I 
am speaking, every physician had to know 
Latin virtually as well as his mother tongue, 
and the better educated also knew Greek. 
It was the possession of the Latin language 
that made it possible for men to study and 
to teach in any university in Europe, 



enabling Sydenham to go to Montpellier 
and Harvey to Padua. I am one of those 
who regret to see the Latin language 
disappearing from the college curriculum. 
A fair amount of Latin and a little Greek 
are of inestimable value to the medical 
student and the physician. 

The Edinburgh school is of special interest 
to Americans, as it was there, under CuIIen 
and others, that John Morgan, the founder 
of the medical school of the University of 
Pennsylvania, the first medical school in this 
country, was educated as well as William 
Shippen, Jr., Benjamin Rush, Samuel Bard 
and many other pioneers. 

One of Boerhaave's greatest pupils, Van 
Swieten, was called to Vienna by Maria 
Theresa and there laid the foundation for 
Vienna's subsequent position as a center 
of clinical teaching. Being overwhelmed 
with practice, Van Swieten in 1754, called 
Anton de Haen, also a pupil of Boerhaave, 
from the Hague to take charge of clinical 
teaching in Vienna. De Haen received the 
enormous salary of five thousand florins in 
order that he might devote himself exclu- 
sively to teaching. He was thus the first 
of full-time clinical teachers; but as the 
position yielded the munificent income just 
mentioned, his problem was not quite as 
difficult as that of professors in American 
schools confronted with the question of de- 
ciding between full- or part-time teaching. 
There are other reasons why De Haen 
should be remembered. He reintroduced the 
Hippocratic practice of allowing fever pa- 
tients to have fresh air. On the basis of the 
doctrine of crises it had become the custom 
to swathe and cover fever patients and keep 
every breath of air from them, a practice 
that has not altogether died out among our 
foreign population, especially among the 
Italians. 

De Haen espoused the study of bowel 
excretions as a means of diagnosis and 
prognosis. This study, though not pursued 
in quite as unscientific a manner as was 



The Rise and Early History of Clinical Teaching 



145 



that of water casting, was very popular 
among medical men, which fact led the 
satirical Gideon Harvey, physician of 
Charles II, to speak of doctors as "medici 
stercorarii qui morbos per anum expellunt." 
One of De Haen's assistants, a Jesuit priest 
by the name of StoII, deserves to be men- 
tioned in a history of clinical teaching. Aside 
from having the questionable honor of being 
the father of the bilious diathesis, which has 
dragged itself through the ages to this 
day, he has the greater distinction of being 
one of the first to insist upon thorough 
physical examinations. He did not, how- 
ever, resort to percussion, though he writes 
that in pleurisy the percussion note is like 
that of the thigh. 

The impetus given to clinical teaching by 
these men endowed the Vienna school with 
a wonderful reputation, which later great 
clinical teachers maintained until the out- 
break of the world war. 

The French school of clinical teaching 
began a little later and passed through 
numerous vicissitudes. Although clinical 
teaching was proposed as early as 1562 by 
one Pierre de la Ramee, practically nothing 
was done until the close of the eighteenth 
century. It is doubtful whether anything 
could have been done in Ramee's time, for 
one physician then had charge of about a 
thousand beds in the Paris hospitals. La- 
menting the utter inadequacy of the teach- 
ing of medical students, Ramee exclaimed: 
"de nouveau medecin, cimetiere boussu." 
About two hundred years later (1778) Duch- 
annoy and Jumelin proposed the reintroduc- 
tion of clinical teaching. Arguing in favor 
of such teaching they expressed themselves 
as follows: "Young medical students may 
reasonably be regarded after their studies 
as a body of young soldiers who, abandoned 
to themselves and without leaders, ravage 
the provinces of a country which they 
should protect and succor." Their sugges- 
tion and protests were of no avail, and as 
late as 1787 the Royal Society of Medicine 



was compelled to make the statement that 
in France no physician had studied his art 
at the bedside of a patient. In not a single 
one of the thirty-two medical faculties of 
France was there any clinical teaching 
worthy of the name prior to the Revolution. 
Desault, in 1787, and Corvisart, in 1788, 
must be looked upon as the founders of clin- 
ical teaching in Paris. During the French 
Revolution all the old institutions and cor- 
porations were overturned. The medical 
faculty and the academy of surgery were 
abolished; the masters of medicine had no 
place to exercise their teaching, and the stu- 
dents had no schools, no instruction. Two 
courageous men, Forcray and Thorat, pro- 
tested publicly against the prevailing politi- 
cal spirit which "seeks to destroy every- 
thing and to build up nothing"; an utter- 
ance that reminds us of the charge so fre- 
quently made to-day against Bolshevism. 

On an earlier page I spoke of Morgagni 
and the influence of his work in morbid 
anatomy upon the teaching of medicine. 
Morgagni, as the founder of the anatomic 
school, placed the habitat of disease in 
the organs instead of in the humors. But 
neither he nor his immediate successors di- 
vined any relation between the diseases of 
various organs. Another great generaliza- 
tion was necessary, and that we owe to 
Francois Xavier Bichat (1 771-1802), who 
by showing that there was a similarity in 
the tissues composing the different organs 
of the body, became the founder of general 
anatomy. From his day onward disease was 
placed not in the organs as a whole but in 
the tissues composing them, and the fact be- 
came established that the same tissues in 
different organs might be subject to the 
same disease processes. It remained for the 
great Rudolph Virchow to carry the ana- 
tomic idea one step farther by his formula- 
tion of the cellular doctrine, under the «gis 
of which morbid anatomy has made enor- 
mous strides and maintains itself until 
this day. 



146 



Annals of Medical History 



Toward the end of the eighteenth century 
a powerful impetus was given to clinical 
teaching by John Peter Frank (1 745-1 821). 
Of a restless, roving disposition, Frank 
taught at Padua, Vienna, Gottingen, in 
Russia, and, for a brief period, in Edin- 
burgh. The Edinburgh method of long 
discourses on certain diseases, without 
special reference to any particular case, in 
other words, the didactic lecture, did not 
appeal to him. In his courses he divided 
his students into two groups, the auscul- 
tants, who did not take part in practical 
demonstrations, and the practicants, who 
participated in the practical exercises. Be- 
lieving that the functions of the teacher 
were to teach the healing art, he totally 
ignored incurable cases as being of no 
moment. He established a mortuary so that 
one could preserve a patient and be sure 
that he was dead before beginning the au- 
topsy. His instructions to students are of 
interest: the history must be full of de- 
tails, must be carefully taken and kept up 
from week to week. If the patient died the 
student had to read the history at the 
autopsy. The student who had assisted in 
the morning had to come back in the eve- 
ning at a definite time to visit his patient. 
If any patient was seriously ill, the pro- 
fessor himself came. John Peter Frank, as 
well as his son Joseph, was an ardent sup- 
porter of the fantastic doctrines of John 
Brown, who was responsible for the pro- 
miscuous and intensive bleeding in vogue 
at the end of the eighteenth and at the be- 
ginning of the nineteenth century. Brown- 
ianism, though originating in Edinburgh, 
found its most zealous advocates in Ger- 
many and in America, particularly in 
Philadelphia. 

One of the greatest advances in clinical 
teaching, indeed in the whole practice of 
medicine, came about through a discovery 
made in the latter half of the eighteenth 
century, but not fully utilized until fifty 
years or more afterwards. In 1761, Leopold 



Auenbrugger, a modest physician connected 
with the so-called Spanish hospital of 
Vienna, published a small booklet of ninety- 
five pages which he called, "Inventum 
Novum ex Percussione Thoracis Humani 
ut Signo Abstrusos Interni Pectoris Morbos 
Detegendi," in which he showed that val- 
uable information might be obtained from 
striking the chest with the finger or, as 
he termed it, by percussion. The work 
remained unnoticed. Even his great fellow- 
citizen, Van Swieten, in a book on pul- 
monary phthisis and empyema published 
in 1765, does not mention percussion. 
A Frenchman, Rogieres de la Chassagne, 
of Montpellier, translated the work into 
French and incorporated it as an appendix 
to a manual on pulmonary diseases, but so 
little did he think of percussion that he 
especially said that it would never occur 
to him to use such an absurd method. 7 

It was Napoleon's physician, Corvisart, 
who by translating the little work of 
Auenbrugger into French gave the method 
its second birth. Immediately percussion 
became widely popular, with the result 
that the Paris school under Louis, Laennec 
and Piorry was for a time the Mecca of 
those seeking clinical instruction. Through 
the application of Auenbrugger's methods, 
and through the discovery of the stetho- 
scope, physical diagnosis was advanced 
by leaps and bounds, almost to the stage 
in which we now have it. Notwithstanding 
the brilliance of the Paris medical faculty 

7 Another author had the hardihood to write as 
follows: "La clinique, ou la Iecon medicale au lit 
du malade (tel est Ie sens du mot clinique), se 
reduit maintenant a I'exploration sous toutes les 
formes: percussion, auscultation, mensuration et 
autres procedes qu'on qualifie ridiculement de 
scientifiques, et qu'on met volontiers en relief et 
en grande veneration aupres de la sotte majorite, 
en les affublant de noms etranges, bizarres, hy- 
brides, Ie plus souvent absurdes, surtout quand ils 
sont empruntes de la Iangue grecque, en depit de 
la Iogique et de I'etymologie." (Guardia: "La Mede- 
cine a travers les Siecles," p. 724.) 



The Facies Hippocratica 



147 



at this period, it had a great and worthy- 
rival in the Dublin school, in which perhaps 
the best clinical instruction of the world 
was given in the middle of the last century. 
Graves and Stokes took their students with 
them into the wards of Meath Hospital 
and inaugurated the type of clinical bedside 
teaching in vogue at the present day. I 
have elsewhere published 8 the history of 
these great Irish clinicians, as well as that 
of Corrigan and Cheyne, all men who in 
power of observation, in keenness of analy- 
sis, and in the exercise of common sense, 
have not been surpassed in any land. In 
England medical teaching early took on a 
practical character. The reasons for this 
change are to be found partly in the prac- 
tical type of mind of the English and their 
innate aversion to philosophical hypotheses, 
and partly in the fact that in England 
medical schools were not as on the Conti- 

*Tbe Johns Hopkins Hosp. Bull., Bait. vol. 
xxiv, no. 270, August, 1913. 



nent, integral parts of universities, but 
were in intimate relation with the metro- 
politan hospitals where some of the phy- 
sicians took pay pupils with them on their 
rounds. 

The preeminence of the French school 
did not last long. Dominated by the spirit 
of Laennec, its great fault was a disre- 
gard of physiology. In overemphasizing 
anatomy, gross and microscopic, it ignored 
the fundamental fact of biology — that form 
is an expression of function. The Vienna 
school soon became preeminent as the center 
of clinical teaching, and, as I have said 
above, remained so until the outbreak of 
the War. 

I shall not carry the subject beyond this 
point. The next great step in the progress of 
clinical teaching came through the con- 
junction of the work of the laboratory with 
the work at the bedside. That step, which 
constitutes the greatest advance contributed 
to the teaching of medicine by our own time, 
lies beyond the scope of this essay. 



THE FACIES HIPPOCRATICA 



In acute diseases, the physician will note 
the following: he will consider first of all the 
patient's expression of countenance to see 
if it is like that of healthy people, but above 
all to see if it is like the patient's own natural 
appearance. This would be the most favor- 
able facial expression, and the more it is 
departed from the greater the danger. It 
will have attained the last degree of altera- 
tion when the nose is sharpened to a point, 
the eyes sunken, the temples depressed, in 
relief, the ears cold and contracted, the 
lobes of the ears detached, the skin of the 



forehead dry, tense and arid, the skin of the 
whole face yellow or black, livid or leaden. 
If the patient have this appearance at the 
beginning of the disease, and if the condition 
is not explicable from the other symptoms, 
inquire if the patient has lost sleep or been 
purging or has suffered from hunger; if 
any of these causes are owned to, the danger 
is much less; and it can be decided in a day 
and a night whether this facial appearance is 
due to these causes or no. If not, and if the 
symptoms do not subside, then death is at 
hand. Hippocrates. "Prognostics." 2. 



NAPOLEON'S CAMP AT BOULOGNE 



By REGINALD FITZ, M.D., 1 

BOSTON, MASS. 



MOST text books of French, 
English, and American his- 
tory give a very brief de- 
scription of that phase of 
Napoleon's history dealing with his pro- 
posed invasion of England between 1803 
and 1805. The events leading up to the 
establishment and demolition of the French 
camp at Boulogne, and an outline of its 
medical organization are of interest, how- 
ever, to all medical officers who have been 
stationed in that city between 191 4 and 
1918. 

At the beginning of the nineteenth cen- 
tury France was at war with Austria and 
Great Britain, and in a condition of armed 
neutrality with Russia, Prussia, Sweden, 
and Denmark. A successful Italian cam- 
paign against Austria resulted in the 
Treaty of Luneville in 1801. The Peace of 
Amiens was concluded with the British in 
1802, after they had driven the remains of 
the French Army from Egypt and had cap- 
tured Malta. The essential question in the 
latter negotiation was the control of the 
Mediterranean. After a long controversy, 
England agreed to withdraw from Malta 
in favor of some neutral power, although 
deferring evacuation because the island lay 
in an important strategic position between 
the western and eastern extremities of the 
Mediterranean, and because Napoleon's 
recognized ambition was to acquire a colo- 
nial empire. In May 1803, a year after the 
Treaty was signed, Napoleon demanded the 
immediate release of Malta. England an- 
swered by seizing 1200 French and Bata- 
vian ships and by withdrawing her ambas- 
sador from Paris. Napoleon, feeling that 
the state of Europe was sufficiently quiet, 
determined to invade England with a force 
of 150,000 men, 10,000 to 15,000 horses, and 



enough artillery, siege guns, equipment, 
food and munitions to last for at least three 
weeks of fighting during which time extra 
supplies could be sent over. Such a plan 
demanded a large sum of money and the 
suitable organization of a combined army 
and navy. 

A reference to the history of the United 
States explains Napoleon's method of financ- 
ing his expeditionary force. During the 
seventeenth century, the French had gradu- 
ally extended their explorations in America 
westward along the Great Lakes. In 1673 
Joliet and Marquette penetrated to the 
upper waters of the Mississippi River, and 
in 1 68 1 Robert Cavelier de la Salle went 
down the river to its mouth where he tried 
to form a colony. This first attempt failed, 
but in 1699 Louis XIV detailed two Cana- 
dian Frenchmen named Iberville and Bien- 
ville to found a second colony at the same 
place, which became permanent. The terri- 
tory on the western side of the river was 
called Louisiana, in honor of the King, and 
a few years later the city of New Orleans 
was founded. 

After this, French colonies gradually de- 
veloped along the river with the idea of 
uniting Canada and Louisiana by a chain. 
In the meantime, the English had begun 
to direct their attention to trade in the 
land west of the Alleghanies so that in 1755 
French and English interests in America 
conflicted and a war broke out. A year 
later this merged into the Seven Years' 
War in Europe in which were involved 
England and Prussia against France, Spain, 
and Austria. England and Prussia were 
successful. By the Treaty of Paris, 1763, 
France was compelled to give Great Brit- 
ain all French possessions in North Amer- 
ica east of the Mississippi River, Spain 



1 Major, United States Army Medical Corps, Base Hospital No. $. 
148 



Napoleon's Camp at Boulogne 



149 



gave Great Britain her American colony 
of Florida, France gave Spain, to compen- 
sate for this loss, all French possessions 
west of the Mississippi River as well as the 
island on which New Orleans stands. Fi- 
nally, the treaty provided that British ves- 
sels should enjoy the free navigation of the 
river. 



in exchange for the Grand Duchy of Tus- 
cany which was to be given to the Duke 
of Parma, son-in-law to the King of Spain. 
The effect of this act was felt in America 
two years later, when the Spanish Gov- 
ernor of New Orleans withdrew the "right 
of disposal" from American colonists, pre- 
sumably so that Louisiana might be hand- 




Boulogne harbor in 1776, before the camp was established. 



In 1783, after the War of Independence, 
the western boundaries of the United States 
were agreed to be those of the British Colo- 
nies according to the Treaty of Paris, and 
navigation of the Mississippi River con- 
tinued to be free to United States ships. 
The latter clause was modified in 1795 D Y 
Thomas Pinckney, who made a new treaty 
with Spain. As a result, that power agreed 
to designate "a right of disposal" by which 
American goods might be stored free of 
duty in Spanish territory while awaiting 
transshipment from river-going boats to 
ocean boats. 

A part of Napoleon's schemes for French 
colonization had resulted in 1800 in the 
secret treaty of San Ildefonso with Spain, 
by which Louisiana was returned to France 



ed over to France free of all encumbrances. 
This act aroused the settlers so much that 
they were eager for war. They believed 
that as long as Spain, — a weak nation and 
growing weaker, — held Louisiana, the de- 
velopment of the United States in the west 
would be undisturbed, but with France in 
control, the situation would be different. 
President Jefferson wrote the American 
minister at Paris that rather than see 
France in possession of Louisiana, the 
United States would combine with Great 
Britain to destroy the French power at 
sea. At the same time he thought that the 
action of the Spanish Governor in with- 
drawing "the right of disposal" might be 
unauthorized, so he restrained popular opin- 
ion in America for five months until he was 



150 



Annals 0/ Medical History 



informed by the Spanish minister that "the 
right of disposal" would be restored. Final- 
ly he sent Monroe to Paris in January 1 803 
as a special envoy to attempt to buy Louisi- 
ana. 

In the meantime, Napoleon's war with 
the British had become imminent and he 
was already planning the invasion of Eng- 
land. At about the time Monroe arrived in 



at a distant point and gradually cruise or 
fight its way to the designated port. It 
seemed probable that a successful landing 
could be made if the channel were block- 
aded from the English for even a few days. 
The closest co-operation between the army, 
the navy, and the engineers, who were to 
build the boats, was necessary to carry out 
such an offensive. 




A view of the Boulogne camp in 1803. The picture illustrates the manner in which the harbor had been widened and 
how the boats were stored. Troops are seen drilling on the beach. The coast of England is visible at the extreme right. 



Paris, Napoleon took up the question of 
the sale of Louisiana on his own account. 
The transaction was completed in April 
1803, a month before the English embassy 
left France. Louisiana was sold to the 
United States for sixty million francs and 
Napoleon had a large sum of money to 
draw on. 

Napoleon's plan for his English campaign 
was, in a general way, as follows: A large 
force of troops was to be trained and equip- 
ped at a French port having a harbor in 
which enough small fast ships could be 
stored to transport the army across the 
channel. The crossing was to be protected 
by the French fleet, which was to assemble 



Boulogne was selected as the point of 
embarkation. The city was at the mouth 
of the narrow river Liane, which was of 
such configuration and formation that it 
could be widened and made into a large 
harbor capable of storing a great number 
of small boats. There were plateaux on 
either side of the mouth of the river, ex- 
posed to the weather but nevertheless suit- 
able for large concentration camps. Second- 
ary camps could be established at two near- 
by inlets: one at Etaples and Montreuil to 
the south, and another at Ambleteuse and 
Wimereux to the north. Finally, the port 
lay close to England and the prevailing 
channel current and wind would tend to 



Napoleon's Camp at Boulogne 



151 



help send the fleet to a point on England's 
coast fairly opposite so that the time spent 
in transshipment would be short. For these 
reasons Napoleon chose Boulogne as a 
starting point of the invasion of England. 
He hoped that his army could safely row 
or sail across the channel when the sea was 
quiet, possibly in a fog or after a storm 
when the British fleet would be rendered 
useless by weather conditions. 

Napoleon visited Boulogne for the first 
time in June 1803 to supervise the begin- 
ning of his undertaking which he hoped to 
start early in the next winter. A camp, 
called the Camp of Saint Omer, was estab- 
lished on either side of the mouth of the 
Liane large enough to hold 36,000 men. A 
second camp for 24,000 was made at Eta- 
ples and Montreuil. A third camp was set 
up at Wimereux and Ambleteuse to be used 
for the troops sent down from Lille, Douai 
and Arras. 

Boulogne City was also taken over by 
the army. Offices, storehouses, and hospi- 
tals were made from the larger houses and 
farms. The men were put in barracks or 
tents as they first came in, and the horses 
were stabled in rapidly constructed sheds. 
Food supplies and wood for buildings were 
requisitioned from Boulogne and its envi- 
rons to a large extent, though such staples 
as flour, rice, salt meat, cheese, wine and 
brandy were sent from Russia, Sweden and 
Holland. 

Five to six thousand professional wood 
and metal workers were conscripted to be- 
gin immediate shipbuilding; 20,000 sailors 
and 10,000 men were required at once for 
various labor details. The different units 
were hurried to Boulogne, and as they ar- 
rived were made to dig in the harbor or to 
construct barracks, ships, and roads. They 
were clothed like workmen, shod in sabots 
to keep their feet dry, and from the outset 
were well lodged, well fed, and well paid. 
As soon as enough ships were built, the sol- 
diers were drilled at loading, rowing, sail- 



ing, and landing, so that each man knew 
his position in his boat and exactly how to 
act. Drills were held by night as well as by 
day, and in storms or smooth water in or- 
der to be prepared for all weather condi- 
tions. 

The English fleet was able to move up 
and down the coast in front of Boulogne so 
various forms of protection were construct- 
ed. Forts were built on either side of the 
entrance to the harbor, big guns were 
mounted along the coast, and a wooden 
fort was set up in the water at the mouth 
of the river. Thus in a few months, the lit- 
tle fishing city was transformed into a large 
and active military centre. 

Napoleon returned to the city in Sep- 
tember 1803. By this time the shipbuilding, 
camp construction, and concentration of 
troops had advanced materially. The Brit- 
ish offered difficulties by shelling the town 
from the channel frequently, and by send- 
ing in small landing parties which were able 
to do considerable damage. Since a large 
part of the construction work and boat drill 
was done on the beach when the tide was 
low, Napoleon devised two new methods to 
keep the British at longer range. One was 
the use of explosive bullets which did far 
more damage than a simple penetrating 
bullet. The other was the use of "subma- 
rine batteries" which were ranged along 
the beach at different levels, covered by 
water at high tide, but effective at low tide. 

At this visit in September 1803, Napo- 
leon gave up the idea of trying to start the 
expedition at once, and decided to wait un- 
til the following summer. By June, 1804, 
after the camp had been occupied for a 
year, the harbor was completed, nearly 
2000 boats were built, and an army of 
150,000 was assembled. The men were so 
well trained that all could getj^into the 
boats with their entire equipment in three 
or four hours, and they had becomeprac- 
tised rowers and sailors. Napoleon's chief 
naval advisers, Admirals Decres and Bruix, 



152 



Annals 0/ Medical History 



however, asserted that the navy was not 
strong enough to offer the necessary pro- 
tection to the army even under most favor- 
able conditions. Therefore the start of the 
expedition was postponed for a second 
time. 




Napoleon's Column at Boulogne. The review was held 

near this spot. The foundation stone was laid in 1804, 

by the Grand Army as a mark of devotion to the Emperor. 

The monument was completed in 1845. 

Napoleon moved his headquarters from 
Boulogne to Pont a Briques and returned 
for a tour of inspection on July 20, 1804. 
He decided to hold a review on his birth- 
day, August 1 6th, using the occasion to 
distribute the Cross of the Legion of Honor 
to certain of his veteran soldiers who were 
in camp, and at the same time to infect all 
his troops with his own enthusiasm and to 
celebrate the proclamation of the Empire, 
which had occurred on the 18th of May. 

Various generals, dignitaries and ladies 
from the neighboring country sat in a gaily 
decorated grandstand close by. The troops 
were massed about this centre in tiers ex- 
tending almost as far as the eye could see; 
platoons of infantry were nearest, and on 
the outskirts mounted soldiers. Napoleon 



himself faced inland and was surrounded 
by 100,000 of his men. He stood up and 
explained what the Legion of Honor meant. 
The artillery fired salutes from their em- 
placements all around, drums beat, and 
trumpets sounded. The new members of 
the Legion of Honor marched past Napo- 
leon's throne to receive their crosses, offi- 
cers and men together, each swearing to 
shed his blood in England if necessary, and 
to make his country and commander su- 
preme in the world. The British fleet helped 
to add to the excitement of the day when 
some raiders came over and met the French 
in front of the harbor. A sharp cannonade 
took place, which the spectators of the re- 
view watched through glasses with great 
interest. 

After this activity in the camp there was 
another year of monotony only interrupted 
by daily marches and drills. It became in- 
creasingly obvious that the expedition 
would fail unless the French navy did its 
share. In the early spring of 1805 its main 
body was in two squadrons, one under Ad- 
miral Villeneuve cruising in the Mediterra- 
nean, and the other under Admiral Gan- 
teaume blockaded in the harbor of Brest. 
Napoleon directed Villeneuve to cruise to 
the West Indies where Ganteaume was to 
meet him. By such an extraordinary ma- 
noeuvre the true purpose of the fleet would 
be hidden from Admiral Nelson, and such 
a combined fleet would be strong enough 
to take control of the channel from the 
British ships guarding it. 

Villeneuve left Toulon on March 30th ac- 
cording to schedule. He arrived at Mar- 
tinique on the 14th of May, where he was 
to wait forty days (until June 23d) for the 
other squadron. His men developed sick- 
ness, possibly yellow fever, and a large 
number deserted. So he started for a short 
cruise to the Barbadoes where the English 
had an important base, to kill time and 
prevent further desertions. He captured a 
convoy of vessels on the way, and was in- 



Napoleon's Camp at Boulogne 



r 53 



formed that Nelson with a large fleet was 
on the high seas in pursuit. He made up 
his mind to take no further chances but to 
turn about and sail for Europe. He arrived 
at the Azores on June 30th, having heard 
nothing of Ganteaume and giving up hope 
of meeting him. From there he started to- 
ward Finistere and the channel. The wind 
changed off the Cape, and sickness again 
broke out amongst his men. He became so 



perhaps allow Admiral Ganteaume to es- 
cape and what was left of one or both 
fleets would proceed to Boulogne. Ville- 
neuve sailed from Ferrol on August 10th, 
but instead of obeying Napoleon and at- 
tempting to relieve Brest, he acted on his 
own responsibility and went south to Ca- 
diz. 

At the time, Napoleon was at Boulogne 
and in a fever of impatience and eagerness. 




The Boulogne camp in 1805. The fortifications at the mouth of the harbor are complete. The port is full of ships. 

The wooden fort is seen at the left of the picture. 



much discouraged and depressed that he 
changed his mind and decided to sail for 
Ferrol to get reinforcements and news. He 
met a part of the British fleet under Ad- 
miral Calder on the way, and fought an 
indecisive battle owing to adverse wind, 
untimely fog, and partly owing to his own 
lack of aggression. However, he made the 
port on the second of August without seri- 
ous casualties. 

In the meantime, Ganteaume had not 
succeeded in escaping from Brest. When 
Napoleon heard that Villeneuve had re- 
turned to Ferrol, he ordered him to pro- 
ceed to Brest at once and engage the Brit- 
ish fleet at any cost. A battle there would 



He felt convinced that his army was as well 
trained and equipped as possible, that the 
journey across the channel was nothing 
more than a movement of troops across a 
wide ditch, and that if the navy made him 
master of the channel for only three days 
he could put an end to England. When he 
heard of Villeneuve's desertion on August 
22d, he was almost out of his mind with 
rage and disappointment. His burst of tem- 
per was short lived, though, for he wrote 
Talleyrand on the next day that if the 
French fleet came into the channel he would 
still cut the knot of all coalitions in London. 
On the other hand, if his admirals failed 
him, he would enter Germany, march 



154 



Annals oj Medical History 



through Vienna, take away Venice and all 
of Italy which remained in Austrian hands, 
and chase the Bourbons from Italy. Hav- 
ing pacified the continent, he would return 
to the ocean and work anew at a maritime 
peace. 

As the fleet never came, Napoleon was 
compelled to give up his plans of the inva- 
sion of England and to turn his attention 
to other matters. He left Boulogne for the 
last time on September second, 1805, and 
was soon followed by all troops except three 
regiments and a few other men who stayed 
to protect the boats and stores which were 
abandoned. As a final note to the history 
of the expedition, it is interesting that Ful- 
ton came to Boulogne in 1 805 and attempt- 
ed to convince Napoleon that the army 
should be sent across the channel by steam- 
boat. Inasmuch as the "Clermont" moved 
upstream on the Hudson River two years 
later, it is probable that the necessary 
machinery was nearly perfect when offered 
to the French, and that the idea was not 
so ridiculous as it first seemed. 

As might be expected with such a large 
military project on hand and with such 
genius for detail as Napoleon always show- 
ed, his plan of medical administration for 
the Boulogne camp was remarkably com- 
plete and had been logically evolved. 

Military Surgeons in the i6th Century 

Up to the end of the sixteenth century 
military surgeons were unheard of in 
France, possibly owing to the lack of or- 
ganized armies. The different seigneurs paid 
private surgeons to accompany them on 
campaigns. These surgeons treated such 
men as needed care more or less at hap- 
hazard, and when the campaign was over 
returned to their villages to resume civil 
practice. Many of the wounded who had 
been abandoned on the wayside were treat- 
ed bycharlatans following the army, and 
wereeventually left to the mercy of friend- 
ly peasants or monasteries. 



Ambroise Pare (1 509-1 590) is properly 
considered the first military surgeon in 
France. King Henry IV (1589-16 10) was 
instrumental in developing surgeons as an 
integral part of the army, and his adviser 
Sully ( 1 560-1 641) was the first to organize 
hospitals for the wounded. He introduced 
the "ambulance," which was a mobile hos- 
pital where early treatment could be given; 
stationary hospitals were placed well back 
of the lines for later treatment. Richelieu 
(1585-1642) created regimental surgeons, 
and after 1731, when the Academie royale 
de Chirurgie was founded, all French sur- 
geons of repute went through a certain 
amount of military training. 

Early Military Ambulances 

The French Army Medical Corps, or 
"Service de Sante," was developed further 
during the reign of Louis XV (1715-1774). 
Army medical schools were established at 
which army officers were taught. There 
were seventy military hospitals to which 
"ambulances" were attached and to which 
were allied charity civilian hospitals. In 
times of war a mobile hospital received the 
wounded and evacuated them as quickly 
as their condition allowed to a stationary 
military hospital somewhere near the front. 
These hospitals in turn evacuated their 
cases to the nearest charity civilian hospi- 
tal in the interior. 

The ambulance wagons used for the mo- 
bile hospitals were heavy vehicles which 
carried an immense amount of equipment. 
Each one was drawn by forty horses and 
had a personnel of 134 men. Of these, 41 
were surgeons, and 31 were supposedly 
trained nurses. Each mobile hospital was 
detailed to look after 20,000 men. The great 
objection was that it was unwieldy in bad 
roads and that it had to stay at least three 
miles behind the fighting. The wounded re- 
mained on the field until the day's battle 
was over when they were collected in a 
group. The ambulance approached at its 



Napoleon's Camp at Boulogne 



155 



convenience, which was often twenty-four 
hours later. Many of the wounded died 
through lack of immediate care and were 
abandoned in case of a retreat. 

Napoleon had two remarkable surgeons 
in his command who made notable progress 
in the systematization of military surgery. 
Larrey (1 762-1 842) realized the necessity 
of helping the wounded on the field of bat- 
tle and of removing them under fire. He 
formed the legion of mobile ambulances 
(Legion de I'ambulance volante). Each le- 
gion consisted of three units under the 
command of a major with two aids, twelve 
junior surgeons, and an administrative and 
working force of 340 men. Each unit oper- 
ated twelve light ambulances and four heav- 
ier ones. The light carriages were drawn by 
two horses and carried two stretcher cases. 
The heavier ones were drawn by four horses 
and held four stretcher cases. The wagons 
were well ventilated and were so construct- 
ed that a wounded man could be put inside 
on a stretcher in horizontal position. Band- 
ages and instruments were part of the 
equipment. An officer or nurse could drive 
anywhere for the wounded, dress them on 
the field when necessary, place them in the 
ambulance, and gallop off at top speed to 
a mobile hospital outside the battle zone. 
Percy (1 754-1 825) modified Larrey 's sys- 
tem by sending out trained stretcher-bear- 
ers to render first aid to the wounded and 
to collect and carry them back. 

Napoleon's Medical Organization 

Thus when the camp at Boulogne was 
established, Napoleon's medical organiza- 
tion was somewhat as follows: Trained 
stretcher-bearers collected the wounded on 
the battlefield, applying dressings on the 
spot if necessary, and carried the patients 
to rapidly moving ambulance wagons. 
These,* in time, took the men to the ad- 
vanced^mobile hospital, where further care 
was given. Finally, the wounded were sent 



back to permanent stationary hospitals out- 
side the battle area for treatment until they 
recovered. 

The most modern touch to this system 
was added in Boulogne by Napoleon him- 
self. In 1803 he wrote a letter to the com- 
manding general of the Saint Omer Camp, 
recommending that all the sick should be 
retained in hospitals in the town. He felt 
that there was nothing worse for sick sol- 
diers than travel. Furthermore, men once 
sent away from their own units were lost 
as effective soldiers for long periods of time. 

In order to prevent overfilling the hospi- 
tals in the area, he ordered the establish- 
ment of a convalescent camp big enough 
to contain a thousand men. All patients 
on discharge from the hospital were to be sent 
to this camp for one or several weeks, after 
which time they were to be returned to 
their own units for duty. The men in the 
convalescent camp were to be properly fed 
and exercised, were to be given a daily ra- 
tion of wine and the necessary medicines. 
The medical care of the men was to be un- 
dertaken by regimental medical officers or 
doctors from the hospitals. The military 
side of the camp was to be in charge of a 
senior officer with a sufficient number of 
junior captains and lieutenants. 

Hospital Treatment at Boulogne 

IN 1805 

On the whole, the organization of the 
French camp at Boulogne in 1 803-1 805 
was remarkably comparable to that of the 
British camp there in 19 14-19 18. Both 
armies turned the city into a military cen- 
tre and took for_army purposes various 
civilian buildings making them into store- 
houses, offices, and hospitals. Both armies 
had numbers of men under canvason the 
plateaux at the mouth of the Liane and at 

r 

Wimereux and Etaples. In 1805 the wound- 
ed were collected and dressed on the bat- 
tlefield, * were_taken quickly to advanced 
mobile hospitals, and were later evacuated 



156 



Annals oj Medical History 



to permanent hospitals outside of the bat- 
tle area. Suitable cases were sent to a con- 
valescent camp in order to be returned to 
their proper units for duty and so that a 
man with a minor wound or ailment should 
not be lost for military purposes. In 191 8, 
the wounded were treated in much the 
same fashion. 

Whether or not Napoleon's proposed in- 
vasion of England was feasible as a mili- 
tary project is a debatable question. The 
history of the Boulogne camp is worth re- 
membering in any event, for it was asso- 
ciated with American development and 



helps to illustrate the close fashion in which 
American, British, and French interests 
have combined or conflicted during the last 
two centuries. 



REFERENCES 

"Histoire du Premier Empire." Hamel. 

"Histoire du Consulat et de I'Empire." Thiers. 

"Correspondance du Napoleon Ier." 

"Les Militaires Blesses et Invalides." De Rien- 
court. 

"Dominique Larrey et les Campagnes de la Revo- 
lution et de I'Empire." Duruy. 

"Napoleon: A Short Biography." Johnston. 

"History of the United States." Hawthorne. 

"A Student's History of the United States." 
Channing. 



RHAZES ON THE ONSET OF SMALL-POX 



The eruption of the Small-pox is preceded 
by a continuous fever, pain in the back, 
itching in the nose, and terrors in sleep, 
These are the more peculiar symptoms of 
its approach, especially a pain in the back, 
with fever; then also a prickling which the 
patient feels all over his body; a fullness of 
face, which at times goes and comes; an 
inflamed colour, and vehement redness in 
both the cheeks; a redness of both the eyes; 
a heaviness of the whole body; a great 
uneasiness, the symptoms of which are 
stretching and yawning; a pain in the 
throat and chest, with a slight difficulty in 
breathing, and cough; a dryness of the 
mouth, thick spittle, and hoarseness of the 
voice; pain and heaviness in the head; 
inquietude, distress of mind, nausea and 
anxiety (with this difference, that the 
inquietude, nausea and anxiety are more 
frequent in the measles than in the small- 
pox; while, on the other hand, the pain in 
the back is more peculiar to the small-pox 
than to measles) ; heat of the whole body, an 
inflamed colour and shining redness, and 



especially an intense redness of the gums. 
. . . There is a bad and fatal sort of the 
white and large pustules, viz., those which 
become confluent and spread, so that many 
of them unite and occupy large spaces of the 
body or become like broad circles, and in 
colour resemble fat. As to those white pus- 
tules which are very small, close to each other, 
hard, warty, and containing no fluid, they 
are of a bad kind, and their badness is in 
proportion to the degree of difficulty in 
ripening. And if the patient be not relieved 
upon their eruption, but his condition 
continues unfavorable after it is finished, 
it is a mortal sign. And as to those which 
are of a greenish, or violet or black colour, 
they are all of a bad and fatal kind; and 
when, besides, a swooning and palpitation 
of the heart comes on, they are worse and 
still more fatal. And when the fever in- 
creases after the appearance of the pustules, 
it is a bad sign; but if it is lessened on their 
appearance, that is a good sign. 

Rhazes. "De variolis et morbillis." 

(GreenhiU's translation). 



WILLIAM OSLER, THE MAN 1 
By HARVEY CUSHING 



BOSTON, MASS. 



WHATEVER may be said of 
Sir William Osier in days 
to come, of his high posi- 
tion in medicine, of his 
gifts and versatility, to his contemporaries, 
love of his fellow-man, utter unselfishness, 
and an extraordinary capacity for friend- 
ship will always remain the characteristics 
which overshadow all else. Few so eminent 
and so industrious come in return to be so 
widely beloved for their own sake. Most of 
us do well with what Stevenson advises — a 
few friends and those without capitulation 
— but Osier had the God-given quality not 
only of being a friend with all, high or low, 
child or grown-up, professor or pupil, don 
or scholar, but what is more, of holding such 
friendships with an unforgetting tenacity — 
a scribbled line of remembrance with a 
playful twist to it, a note of congratulation 
to some delighted youngster on his first 
publication, the gift of an unexpected book, 
an unsolicited donation for some worthy 
cause (and giving promptly he gave doub- 
ly), a telegram to bring cheer or consolation, 
an article to help a struggling journal to get 
a footing, a cable such as his last on the day 
of his operation to his old Hopkins friends, 
which was given by them to the press for 
the benefit of countless others who shared 
their own anxiety — all this was character- 
istic of the man, whose first thoughts were 
invariably for others. 

He gave much of himself to all, and 
everyone fortunate enough to have been 
brought in contact with him shared from 
the beginning in the universal feeling of 
devotion all had for him. This was true of 
his patients, as might be expected, and he 
was sought far and wide not only because 
of his wide knowledge of medicine and great 
wisdom, but because of his generosity, sym- 
pathy and great personal charm. It was 



true also — and this is more rare — of the 
members of his profession, for whom, high or 
low, he showed a spirit of brotherly helpful- 
ness untinctured by those petty jealousies 
which sometimes mar these relationships. 
"Never believe what a patient may tell you 
to the detriment of another physician" was 
one of his sayings to students, and then he 
would add with a characteristic twist — 
"even though you may fear it is true"; 
and he was preeminently the physician to 
physicians and their families, and would go 
out of his way unsolicited and unsparingly 
to help them when he learned that they were 
ill or in distress of any kind. And no one 
could administer encouragement, the essen- 
tial factor in the art of psychotherapy in 
which he was past master, or could "soothe 
the heartache of any pessimistic brother," 
so effectively and with so little expenditure 
of time as could he. 

During one of his flying trips to America 
some years ago, as always with engagements 
innumerable, he took time to go from Balti- 
more to Boston for the single purpose of 
seeing a surgical friend with literary tastes 
who for some months had been bed-fast 
with a decompensated heart; and James 
Mumford, for it was he, always said that 
this unannounced visit was what put him 
on his feet again. I knew of his doing the 
same thing for an Edinburgh physician of 
whose illness he heard by chance just as he 
was leaving the steamer, in Liverpool. He 
was due for an address before the British 
Medical Association in Oxford, but without 
hesitation he took the first tram to the 
north and managed to get back to Oxford 
just in time for the address, blithe and gay 
as though he had not spent two nights on a 
train. Indeed he was invariably punctual 
and somewhat intolerant of tardiness in 
others. "Punctuality is the prime essential 



1 An amplification of a note on Sir William Osier which appeared anonymously in the Boston Evening Transcript, January 3, 1920. 

157 



158 



Annals of Medical History 



of a physician — if invariably on time he will 
succeed even in the face of professional 
mediocrity." 

The universal devotion he engendered 
was no less true of those with whom he 
came in contact outside his profession, and 
his points of contact through his varied 
interests were innumerable. Man, woman or 
child — and in children especially he de- 
lighted as they did in him — felt from the 
first moment of meeting a rare fascination 
in his personality. In a poem, "Books and 
the Man," dedicated to Osier and read 
before the Charaka Club, March 4, 1905, 
Weir Mitchell recalls in these three verses 
their first meeting in London twenty years 
before. 

Do you perchance recall when first we met — 
And gaily winged with thought the flying night 
And won with ease the friendship of the mind, — ■ 
I like to call it friendship at first sight. 

And then you found with us a second home, 
And, in the practice of life's happiest art 
You little guessed how readily you won 
The added friendship of the open heart. 

And now a score of years has fled away 
In noble service of life's highest ends, 
And my glad capture of a London night 
Disputes with me a continent of friends. 

On Osier's seventieth birthday, just 
passed, the medical world set out to do him 
honor — unknown to him, for he was one to 
elude public testimonials and did not suffer 
adulation gladly, quick as he was to give 
praise to others. For this occasion many of 
his former pupils and colleagues in Balti- 
more wrote a number of papers containing 
the sort of things rarely said or written 
about a man or his work until after his 
death. Among these papers is one by his 
present successor there, on "Osier the 
Teacher" which deserves quoting in full, 
but which after an enunciation of his traits 
ends with this picture of the man as his 
hospital associates and students remember 
him. 



If you can practice consistently all this, . . . 
and then, if you can bring into corridor and ward 
a light, springing step, a kindly glance, a bright 
word to everyone you meet, arm passed within 
arm or thrown over the shoulder of the happy 
student or colleague; a quick, droll, epigrammatic 
question, observation or appellation that puts the 
patient at his ease or brings a pleased blush to the 
face of the nurse; an apprehension that grasps in a 
minute the kernel of the situation, and a memory 
teeming with instances and examples that throw 
light on the question; an unusual power of suc- 
cinct statement and picturesque expression, exer- 
cised quietly, modestly and wholly without 
sensation; if you can bring into the lecture-room 
an air of perfect simplicity and directness, and, 
behind it all, have an ever-ready store of the most- 
apt and sometimes surprising interjections that 
so light up and emphasize that which you are 
setting forth that no one in the room can forget 
it; if you can enter the sick-room with a song and 
an epigram, an air of gaiety, an atmosphere that 
lifts the invalid instantly out of his ills, that pro- 
duces in the waiting hypochondriac so pleasing a 
confusion of thought that the written list of ques- 
tions and complaints, carefully complied and 
treasured for the moment of the visit, is almost 
invariably forgotten; if the joy of your visit can 
make half a ward forget the symptoms that it 
fancied were important, until you are gone; if you 
can truly love your fellow and, having said evil of 
no man, be loved by all; if you can select a wife 
with a heart as big as your own, whose generous 
welcome makes your tea-table a Mecca; ... if 
you can do all this, you may begin to be to others 
the teacher that "the chief" is to us. 

Little wonder that he was idolized by the 
students. This was natural enough, but he 
in turn took pains to know them by name, 
gave up an evening in each week to succes- 
sive groups of them at his home, learned 
them as individuals and never forgot them. 
And it was the same with his hospital 
juniors, whether they happened to be mem- 
bers of his own staff or not. Preserved among 
some papers I find this characteristic un- 
dated note of circa 1898, concerning an 
early effort which had been submitted to 
him. It is scribbled in pencil on a bit of paper. 

A. A. 1. report! I have added a brief note about 
the diagnoses. I would mention in the medical re- 



William Osler, The Man 



159 



port the name of the House Physician in Ward 
E & the clin. clerk, & under the surgical report the 
name of the House Surgeon who had charge. We 
are not nearly particular enough in this respect 
and should follow the good old Scotch custom. 
Yours, W. O. 

This habit of giving credit to everyone who 
may have been brought into contact with a 
case was most characteristic of the man. 
Even his "Text-Book of Medicine" con- 
tains so many references to places and 
people that it led to these amusing verses 
taken from a long poem by a student which 
appeared in the Guy's Hospital Gazette some 
years ago : 

For why should it matter to usward, 

If Osborn has sent you a screed, 

Or why have you sought a brief mention of Porter, 

Or Barker, or Caton, or Reed? 

I sometimes am seized with a yearning, 

In Appleton's ledger to look, 

What fun it would be if we only could see 

Whether each of them purchased the book! 

But when of the names we are weary 

(Directories muddle the brain), 

We're provided by you with philosophy too 

In the trite Aphorisms of Cheyne. 

Geography also you teach us, 

Until I came under your thrall, 

I don't mind confessing that Conoquenessing 

I never had heard of at all. 

But with all his abundant learning, his 
high spirits, his playful wit and love of a 
practical joke, he was incapable of offending. 
"If you can't see good in people see noth- 
ing." Charitable to a degree of others' 
foibles, even when he had to oppose or to 
fight in public for a principle he did so with- 
out leaving hurt feelings. This lay at the 
bottom of the great influence he exercised 
and the universal admiration felt for his 
character. 

Probably no physician during his life has 
been so much quoted nor so much written 
about, and the chief periods of Osier's 
eventful and migratory career are too well 
known to need more than brief mention. 

His father, a clergyman, Featherstone 



Lake Osier, with his wife, Ellen Pickton, left 
Falmouth, England, in 1837 and settled in 
the Province of Ontario. William, the eighth 
of their nine children, several of whom have 
become highly distinguished in Canadian 
affairs and in the law, was born July 12, 
1849, at Bond Head. A graduate of Trinity 
College, Toronto, in 1868, he took his 
medical degree four years later at McGill 
University; then after two years of study 
abroad, returning to Montreal in 1874, he 
leapt into prominence as the newly ap- 
pointed Professor of the Institutes of Medi- 
cine of his alma mater. A professor at 
twenty-five, in a chair which covered the 
teaching of pathology and physiology ! And 
there followed ten years of active scientific 
work which laid the foundation for his 
subsequent eminence in his profession. 

In 1884 he accepted a position in the 
University of Pennsylvania, and five years 
later was called to Baltimore as Professor 
of Medicine in the newly established Johns 
Hopkins Medical School. There, marrying 
in 1892 Grace Revere, the widow of Dr. S. 
W. Gross of Philadelphia, he remained for 
sixteen years. It was the Golden Age of the 
Johns Hopkins during the presidency of 
Daniel C. Gilman, and during this period 
through his writing and teaching Osier 
became recognized, one may say without 
exaggeration, as the most eminent and 
widely influential physician of his time. 

Many calls to other positions during these 
years met with refusal until in 1904, when 
fifty-six years of age, he accepted the Regius 
Professorship of Physic at Oxford, the most 
honored post in medicine that the United 
Kingdom can offer. Though this position on 
a royal foundation centuries old (Henry 
VIII, 1546) is a sinecure and was doubtless 
accepted to give leisure for literary pur- 
suits, he was not one to take advantage of 
ease. The succeeding fifteen years in Oxford 
represent, if possible, a period of even 
greater activity and more far-reaching influ- 
ence in many directions than the fifteen 



i6o 



Annals of Medical History 



years at the Johns Hopkins, where despite 
his absence his stimulating spirit of work 
for work's sake still reigns. 

Established in a delightful home where 
he and Lady Osier continued to dispense 
their unbounded hospitality, so much so 
that 13 Norham Gardens came to be known 



strict adherence to the humanities, its com- 
fortable spirit of laissez jaire, had drawn 
into its net a restless spirit who knew the 
modern outside world, and he was responsi- 
ble for such changes even in the established 
procedures of the Bodleian as were thought 
impossible of accomplishment, if indeed 



as the "Open Arms," elected a Fellow of modern library methods were really desir- 




A snapshot of Sir William Osier taken in the Bodleian Library in 1909, holding 
open Sir William Stirling-Maxwell's copy of Vesal's Tabulae Anatomicse. 



Christ Church, Woolsey's College, put upon 
the Hebdomadal Council, a small body 
which takes the initiative in promulgating 
all the legislature of the University before 
its submission to Convocation, he was soon 
appointed one of the curators of the Bod- 
leian Library, and elected a Delegate of the 
University Press. There can be no doubt 
but that these latter positions gave him his 
greatest extra-professional pleasure and sat- 
isfaction during his Oxford life, and to the 
Library and the Press he gave largely of his 
time. 

But Oxford, with its hoary traditions, its 



able. But a man, particularly when ener- 
getic, unselfish and likeable, who could talk 
Aristotelian philosophy with the dons at the 
high table and at the same time knew 
science and the value of laboratories as 
well as libraries, could not but leave his 
impression on the ten centuries, more or 
less, of Oxford's habits and customs. 

There were, indeed, many Osiers: the 
physician, the professor, the scholar, the 
author, the bibliophile, the historian, the 
philanthropist, the friend and companion 
for young or old. Though no man loved his 
home more nor kept its doors more widely 



William Osler, The Man 



161 



open to the world, he was in demand every- 
where, and was eminently clubable. Few 
dinners, of the Samuel Pepys Club, the 
Roxburghe or the Colophon Clubs, of the 
inner circle of the Royal Society, of his 
college, failed to be enlivened by his pres- 
ence, and he had just been made a member 
of the famous Johnson Club, one of the 
oldest and most select dining clubs in 
existence. 

His Oxford home, even more than in 
Baltimore, had become such a gathering 
place, particularly for Canadians and Ameri- 
cans, that how the scholar did his work 
was a mystification to many. An omniverous 
reader with a most retentive memory, pos- 
sessed of a rare literary gift and with the 
power of immediately concentrating on the 
thing which was to be done, no matter what 
had occupied his attention the moment 
before or was laid out to be done the 
moment after — these were probably the ele- 
ments of his great productivity. 

With it all he was a writer par excellence 
of countless brief missives — even the frag- 
ment pencilled on a postcard during his 
outings and sent to an unexpecting friend 
whom some incident had led him to recall, 
invariably contained some characteristic 
message, quip or epigram worth preserving. 
During a brief sojourn in Paris in the winter 
of 1908-9, he writes: 

I've just been going through the Servetus Trial 
for Astrology, 1537. 'Tis given in full in du Bou- 
Iay's History of the University of Paris. I wish you 
could see this library. I've wasted hours browsing. 
Meanwhile I've read through six volumes of 
Swinburne. I did not know before of his Children's 
Poems. We are off on the 13th, first to Lyons to 
see Symphorien Champier and Rabelais. We'll 
stop at Vienne to call on Servetus and Appolos 
Revoire, doubtless the father of the late Paul 
Revere. 

He subsequently went down into Italy, 
and some of the readers of a journal of 
medical history may like to trail him by a 
letter and by some picture postcards, on a 



quarter of which he could squeeze much in 

his fine writing. 

Cannes. 
A great coast. Such sunshine. We have been 
here ij^ weeks — delighted with everything. This 
is a gorgeous spot. Where I put the + is the little 
town of Gourdron. They had to get high up on 
account of the Moors. I am thinking of settling at 
Monte-Carlo — they say there is a good opening. 
I lost $.25 in five minutes and then stopped. We 
go to Rome on the 7th. So far as women are con- 
cerned this is the Remnant Counter of Europe. . . . 

Milan. 
I forgot whether I wrote about the Vesal 
Tabulae sex at the San Marco — I think I did. 
Splendid as illustrating the evolution of his knowl- 
edge — also of Calcar as they are very crude in 
comparison with the 1542. Nothing much in 
Pavia — nothing in comparison with Bologna and 
Padua. Library good — no Vesal items of moment, 
not even the 1543. A 1st ed. of Mundinus, but no 
plates. I have not been able to locate a single 
Mundinus MS. — I wonder where they can be. 
The Ambrosiana here is a fine collection. I had 5 
original MSS. of Cardan to look over — the auto- 
biography is complete — he wrote a wonderful 
hand — no wonder the printers liked to get his 
copy. Hopli here has no large stock — tho' the best 
publisher in Italy. Love to the bairns. . . . 

Rome. 

Rome at last! Wonderful! What pigmies we are 
in comparison with those old fellows. So much to 
see and everything intensely interesting. I have 
not yet been to the Vatican Library. Splendid 
bookshops here. I have already got some treasures. 
Redi and Valisneri — splendid editions. So glad of 
your letter today (1 ith). Love to the darlings. 

Florence. 
Yours came this morning — two days late for 
personal attention to your Lang commission. I 
was recalled to Rome (stranded American) and 
I sanctified my fee by buying three copies of Vesal. 
2nd edition, fine one for myself. A first for McGill 
(300 fr. was stiff but it goes for 500!) and another 
for the Frick Library. I was sorry to miss the 
Rhazes — the Brussels Library secured it. I have 
two copies also of the Venice edition of the Vesal. 
Have you one? I will send your list to Lang. They 
are Germans and know their worth. I bought one 
Imperialis for the sake of the Vesal picture — they 
have another which I will ask them to send. The 
Gilbert facsimile is good and the Berengarius. 
Did I tell you I got the original Gilbert at the 



1 62 



Annals 0/ Medical History 



Amherst sale? I got a beauty Aristotle 1476 de 
partibus animalium at Laschers. This place is of 
overwhelming interest — libraries, pictures, etc. The 
Laurentian library is just too splendid for words 
— 7000 chained mss., all in the putei designed 
by Michael Angelo. I have a photo of the end of 

one for you. The book shops are good. B 

one of the best in Europe. He has 500 incunabula 
on the shelves, a Silvaticus — a cuss of no moment 
— of 1476, a superb folio, one of the first printed in 
Bologna — fresh and clean as if printed yesterday 
and such a page! but . . . asks 1500 francs. His 
things are wonderful. But really auction sales (are) 
is the only economical way to get old books. The 
dealers have to put up their prices to pay interest 
on the stock. I am sorry not to have seen the Junta 
Galen — there are 5 Venice editions of that firm! 
By the way the Pitti picture of Vesal is very fine 
— I am looking for a photo — the beard is tinged 
with grey. ... 

Re Alcmeon, see Gomperz Greek Thinkers — he 
was the earliest and greatest of the Magna Graeca 
anatomists. We go from here to Bologna, Padua, 
Venice, &c. I have a set of Votives for the Faculty 
— terra-cotta arms, legs, breasts, yards, eyes, 
ears, fingers — which the votaries hung in the 
^Esculapian temples in gratitude to the God — 
the modern R. C. ones are wretched (tin) imita- 
tions. 

I am in a state of acute mental indigestion from 
plethora — it is really bewildering — so much to see 
and to do. 

Naples. 
Thus far on the trip. Glorious place — glorious 
weather. I wish you were mit. I dreamt of you last 
night — operating on Hughlings Jackson. The 
great principle you said in cerebral surgery was 
to create a commotion by which the association 
paths were restored. You took off the scalp — like 
a p. m. incision — made a big hole over the cerebel- 
lum and put in a Christ Church — whipped cream 
— wooden instrument and rotated it rapidly. 
Then put back the bone and sewed him up. You 
said he would never have a fit again. I said sol- 
emnly, I am not surprised. H-J. seemed very 
comfortable after the operation and bought 3 
oranges from a small Neapolitan who strolled into 
the Queen-Square amphitheatre! I have been 
studying my dreams lately and have come to the 
conclusion that just one-third of my time is spent 
in an asylum — or should bel 

Two years later, in 191 1, he made a 
winter's trip to Egypt and as usual was 



enthusiastic about all he saw and did. Here 
is a somewhat longer letter." 

S. S. "Seti" 
Feb. 22nd, 191 1. 

Such a trip! I would give one of the fragments 
of Osiris to have you two on this boat. Everything 
arranged for our comfort and the dearest old 
dragoman who parades the deck in gorgeous attire 
with his string of 99 beads — each one representing 
an attribute of God! We shall take about 10 days 
to the Dam (Assouan), 580 miles from Cairo. 
Yesterday we stopped at Assiut and I saw the 
Hospital of the American Mission — 200 beds, 
about 20,000 out-patients. Dr. Grant is in charge 
with 3 assistants and many nurses. I found there 
an old Clevelander . . . who had fallen off a 
donkey and broken his ribs, and on the 8th day 
had thrombosis of left leg. He was better, but at 
76 he should have stayed at home. The Nile itself 
is fascinating, an endless panorama — on one side 
or the other the Arabian or the Libyan desert 
comes close to the river, often in great lime stone 
ridges, 200-800 ft. in height; and then the valley 
widens to eight or ten miles. Yellow water, brown 
mud, green fields and grey sand and rocks always 
in sight; and the poor devils dipping up the water 
in pails from one level to the other. We had a 
great treat yesterday afternoon. The Pasha of 
this district has two sons at Oxford and their 
tutor, A. L. Smith, a great friend of his, sent him 
a letter about our party. He had a secretary meet 
us at Assuit and came up the river to Aboutig. 
We had tea in his house and then visited a Manual 
Training School for 100 boys, which he supports. 
In the evening he gave us a big dinner. I wish you 
could have seen us start off on donkeys for the 
half mile to his house. It was hard work talking 
to him through an interpreter, but he was most 
interesting — a great tall Arab of very distinguished 
appearance. A weird procession left his house at 
10 p.m. — all of us in eve. dress, which seemed to 
make the donkeys very frisky. Three lantern 
men, a group of donkey men, two big Arabs with 
rifles and following us a group of men carrying 
sheep — one alive! chickens, fruit, vegetables, 
eggs, etc., to stock our larder. We tie up every eve 
about 8 o'clock, pegging the boat in the mud. 
The Arabs are fine: our Reis, or pilot, is a direct 
descendant, I am sure, of Rameses II, judging 
from his face. After washing himself he spreads 
his prayer mat at the bow of the boat and says 
his prayers with the really beautiful somatic 
ritual of the Muslem. The old Pasha, by the way, 
is a very holy man and has been to Mecca where 



William Osler, The Man 



163 



he keeps two lamps perpetually burning and 
tended by two .eunuchs. He is holy enough to do 
the early morning prayer from 4 to 6 a.m. with 
some 2000 sentences from the Koran. It is a great 
religion — no wonder Moslem rules in the East. 
Wonderful crops up here — sugar cane, cotton, 
beans and wheat. These poor devils work hard 
but now they have the satisfaction of knowing 
they are not robbed. We are never out of sight of 
the desert and the mountains come close on one 
side or the other. Today we were for miles close 
under limestone heights — 800-1000 feet, grey and 
desolate. The river is a ceaseless panorama — the 
old Nile boats with curved prows and the most 
remarkable sails, like big jibs, swung on a boom 
from the top of the masts, usually two and the 
foresail the larger. I saw some great books in the 
Khedival Library — monster Korans superbly illu- 
minated. The finer types have been guarded 
jealously from the infidel, and Moritz.the librarian, 
showed me examples of the finer forms that are 
not in any European libraries. Then he looked up 
a reference and said — " You have in the Bodleian 
three volumes of a unique and most important 
16 cent, arabic manuscript dealing with Egyptian 
antiquities. We have the other two volumes. 
Three of the five were taken from Egypt in the 
17th century. We would give almost anything to 
get the others." And then he showed me two of 
the most sumptuous Korans, about 3 ft. in height, 
every page ablaze with gold, which he said they 
would offer in exchange. I have written to E. W. 
B. Cyclops Nicholson urging him to get the 
curator to make the exchange, but it takes a 
University decree to part with a Bodley book! 
Curiously enough I could not find any early 
Arabian books (of note) in medicine, neither 
Avicenna or Rhazes in such beautiful form as we 
have. I have asked a young fellow at school who 
is interested to look up the matter. We shall have 
nearly a week in Cairo on our return. I went over 
the Ankylostoma specimens with Looss and the 
Bilharzia with Ferguson — both terrible diseases 
here (not the men!) — the latter, a hopeless one 
and so crippling. There were a dozen or more 
bladder cases in the hospital and the polypous 
cholitis which it causes is extraordinary. They 
must spend more money on scientific medicine. 
Looss has very poor accommodations. The labora- 
tories are good, but the staffs are very insufficient. 
The hospital is impossible. I am brown as a 
fellah — such sun — a blaze all day. We reached 
Cairo in one of those sand storms, the air filled 



with a greyish dust which covers everything and 
is most irritating to eyes and tubes. This boat is 
delightful — five — six miles an hour against the 
current, which is often very rapid. The river gets 
very shallow at this season, and is fully eighteen 
feet below flood level. I have been reading Herodu- 
tus, who is the chief authority now on the ancient 
history of Egypt. He seems to have told all of the 
truth he could get and it has been verified of late 
years in the most interesting way. Tomorrow we 
start at 8 for the Tombs of Denderah — a donkey 
ride of an hour. We are tied up to one of Cook's 
floating barge docks , squatted out side is a group of 
natives and the Egyptian policeman (who is in evi- 
dence at each stopping-place) is parading with an 
old Snider and a fine stock of cartridges in his belt. 
P. S. 24th. Have just seen Denderah and the 
Temple of Hathor. Heavens, what feeble pigmies 
we are! Even with steam, electricity and the 
Panama Canal. 

What fun to travel with a spirit like this, 
and he rarely went anywhere without hav- 
ing two or three youngsters on his trail. 
The summer his Oxford decision was finally 
made two of us crossed with him, indeed 
shared the same small stateroom, and, as I 
recall it, were not permitted to pay our 
share. We learned something of his methods 
of work, and had we not been on this inti- 
mate basis he would have appeared to us, 
as to the other voyagers, as the most care- 
free individual aboard. As a matter of fact 
he was always the first awake, and we 
would find him propped up with pillows 
reading or writing, and his bunk was so 
cluttered with books during the whole trip 
that there was scant room for its legitimate 
occupant. He breakfasted while we dressed, 
and then went on with his morning's work 
while the rest of us wandered about the 
deck with good intentions but usually with 
an unread book under our arms. At luncheon 
he would appear; the remainder of the day 
was a continuous frolic. We roped in the 
ship's doctor and got up a medical society 
of the physicians aboard. I find that I have 
preserved the program which he arranged. 



164 



Annals of Medical History 



MEDICO-NAUTICAL STUDIES 

By Members of the North Atlantic Medical Society- 
Edited by 
Dr. Francis Verdon 
of 
S. S. "Campania" 
Perpetual President 

The volume containing about seven hundred pages will be 
issued from the Utopian Press, Thos. More & Sons, Atlantis. 
Price £1. 

CONTENTS 



I. A study of the 'sea-change' 

mentioned in the "Tem- 
pest" as a key to the 
Shakespeare-Baconian 
controversy 

II. The minimal lymph pres- 

sure in the ampullae as a 
cause of sea-sickness 

III. The otoconial rattle in sea- 

sickness. A study in aural 
ausculatory physics 

IV. On Broadbent's theory of 

steady dextral cerulean 
vision as a preventative in 
the disease 

V. A demonstration of the 

centripedal course of the 
neuro-electrical vagal 
waves of Rosenbach, with 
ten charts 

VI. A comprehensive investiga- 

tion on marine phosphenes 
with their relation to 
latitude and longitude 

VII. A statistical inquiry into the 

sequelae of sea-sickness 
in ten thousand consecu- 
tive cases treated success- 
fully with specifics 

VIII. On the chemistry of aqua- 

verdin. A new gastro-cu- 
taneous sea pigment 

IX. A comparative study of the 

effects of prolonged sea- 
sickness on (1) drinkers 
(2) abstainers 

X. The aesthetics of sea-sick- 

ness, with six photo-grav- 
ures from sketches by 
Sargent and Abbey 

XI. Salt as the cause of appendi- 

citis — results of a collec- 
tive investigation show- 
ing the extraordinary fre- 
quency of the disease after 
sea voyages 

XII. A sociological inquiry upon 

the influence of sea travel 
on the birth rate of differ- 
ent communities 



By James Tyson 
By Harvey Cushing 
By Maitland Ramsay 

By William Osier 

By T. McCrae 
By J. A. Andrews 

By Francis Verdon 
By Campbell Howard 

By T. G. Roddick 

By Henry Barton Jacobs 

By Herbert Bruce 
By Jas. Stewart 



All this was doubtless very frivolous but 
he spent no idle hours, and getting enjoy- 
ment out of trifles at the proper time and 
making others participate was as character- 
istic of the man as his hours of industry 
when sitting down to the day's work. 

Few scholars have received more recog- 
nition for their work, few have received so 



many honors nor carried them so well. With 
it all he preached and practiced humil- 
ity. To quote from one of the essays in 
" Aequinimitas" : 

"In these days of aggressive self-assertion, 
when the stress of competition is so keen and the 
desire to make the most of oneself so universal 
it may seem a little old-fashioned to preach the 
necessity of this virtue, but I insist for its own 
sake, and for the sake of what it brings, that a due 
humility should take the place of honour on the 
list." 

His charm as a writer had much to do with 
his great success as a teacher, and his 
bibliography, covering a period of 49 years, 
is most extensive — 730 titles, including his 
collected essays and addresses, having been 
assembled by Miss Blogg in commemora- 
tion of his last birthday. There is a great 
range of subjects beside those pertaining to 
medicine and medical history. His "Text- 
Book of Medicine," of which nearly 200,- 
000 copies have been printed, kept con- 
stantryiunder revision,transIatedinto French, 
German, Spanish and Chinese and now 
entering on its ninth edition, was written 
during his early years in Baltimore and 
since 1892 has been read — nay devoured — 
by countless medical students and graduates 
alike. It remains probably the most used 
and most useful book in medicine today. 

As is well known, his attachment to 
young men and his fondness for literary 
allusion once got him into trouble by a 
quotation from "The Fixed Period," one 
of Anthony TroIIope's rarer novels, which 
probably few have read and which is diffi- 
cult to obtain, as the present writer knows 
to his cost. Thus the remark about chloro- 
form, really TroIIope's, was made in the 
course of his farewell address to his devoted 
Baltimore colleagues and friends, many of 
whom were over 60, an age he was approach- 
ing himself. And he would have been the 
last to have offended them. It was an 
address full of deep feeling for all that he 
was soon to leave behind, but the represen- 




William Osler, The Man 



165 



tatives of the press who were present 
singled out this one remark to be headlined. 
The sad feature of this episode is that it 
stands as one of the best examples of the 
heartlessness of the press when an oppor- 
tunity offers itself for copy, no matter who 
may be sacrificed. On the eve of his depar- 
ture from America the notoriety probably 
hurt him considerably, though he wisely 
made no reply, not even at the great ban- 
quet which was given him at the time by 
the profession of the country, on which 
occasion Weir Mitchell presented him with 
the rare Franklin imprint of Cicero's "De 
Senectute." He knew when to keep his 
tongue as with a bridle. 

His IngersoII Lecture on "Science and 
Immortality" is a good example of his 
charming literary style, and there is an 
interesting story of how he came to accept 
the lectureship, which others must tell. It 
was given late in 1904, a few months before 
his transference to Oxford, when he was in 
great demand everywhere and by everyone 
and could find no time for its preparation. 
Finally, a few days before the date of the 
occasion, he slipped away one night to New 
York, hid in the University Club, and 
wrote the lecture in a single morning. It is 
so full of allusion that to appreciate it fully 
one must read it with the Bible in one hand, 
the "Religio Medici" in the other, and "In 
Memoriam" near by. In this he gives his 
own conjessio fidei to the effect that, as 
Cicero had once said, he would rather be 
mistaken with Plato than be in the right 
with those who deny altogether the life 
after death. 

At seventy in the forefront of activities 
innumerable, of unusual physical vigor and 
buoyancy, coming of a long-lived race, 
William Osier's death may be regarded as 
a consequence of the war. No human being 
loathed strife more than he; few had been 
as successful in avoiding it in any guise. 
This characteristic made him suffer unduly 
from the very outbreak of the conflict. He 



nevertheless threw himself into it with 
characteristic energy in connection with the 
War Office, on committees, in hospitals, and 
as a senior consultant to the Forces he 
received a Colonel's commission. The Brit- 
ish reply to the famous German professional 
note issued early in the war was, I believe, 
written by him and shows the man's spirit 
and, as always, his charity. The opening 
and closing paragraphs may be quoted: 

We see with regret the names of many Ger- 
man professors and men of science, whom we 
regard with respect and, in some cases, with 
personal friendship, appended to a denunciation 
of Great Britain so utterly baseless that we can 
hardly believe that it expresses their spontaneous 
or considered opinion. We do not question for a 
moment their personal sincerity when they express 
their horror of War and their zeal for "the achieve- 
ments of culture." Yet we are bound to point out 
that a very different view of War, and of national 
aggrandizement based on the threat of War, has 
been advocated by such influential writers as 
Nietzsche, von Treitschke, von Biilow, and von 
Bernhardi, and has received widespread support 
from the press and from public opinion in Ger- 
many. This has not occurred, and in our judgment 
would scarcely be possible, in any other civilized 
country. We must also remark that it is German 
armies alone which have, at the present time, 
deliberately destroyed or bombarded such monu- 
ments of human culture as the Library at Louvain 
and the Cathedrals at Rheims and Marines. No 
doubt it is hard for human beings to weigh justly 
their country's quarrels; perhaps particularly 
hard for Germans, who have been reared in an 
atmosphere of devotion to their Kaiser and his 
army, who are feeling acutely at the present hour, 
and who live under a Government which, we 
believe, does not allow them to know the truth. 
Yet it is the duty of learned men to make sure of 
their facts. . . . 

The German professors appear to think that 
Germany has, in this matter, some considerable 
body of sympathizers in the Universities of Great 
Britain. They are gravely mistaken. Never within 
our lifetime has this country been so united on 
any great political issue. We ourselves have a real 
and deep admiration for German scholarship and 
science. We have many ties with Germany, ties 
of comradeship, of respect, and of affection. We 
grieve profoundly that, under the baleful influ- 
ence of a military system and its lawless dreams 



1 66 



Annals of Medical History 



of conquest, she whom we once honoured now 
stands revealed as the common enemy of Europe 
and of all peoples which respect the Law of Na- 
tions. We must carry on the war on which we have 
entered. For us, as for Belgium, it is a war of 
defence, waged for liberty and peace. 

His only child, Revere, an Oxford under- 
graduate and his father's devoted playmate, 
who too hated strife, on coming of military 
age underwent training as a field artillery 
officer, was commissioned Lieutenant, 
served with his battery with great credit 
for a year in France, and was mortally 
wounded in action September 2, 191 7, in 
the Ypres salient. Thus the great grandson 
of our Paul Revere who roused Lexington 
and Concord lies under a wooden cross in 
Flanders in the corner of a foreign field that 
is forever England. By a strange coincid- 
ence, a group of American officers, who 
knew what grief this would bring, were 
there to bare their heads at his Last Post. 

From this loss, particularly heartrending 
to one of his nature, his father never fully 
recovered. Though unchanged in his out- 
ward dealings with people and affairs, he 
suffered much from insomnia and his health 
was so undermined that he became an easy 
prey to an old enemy, bronchial attacks. 
He finally contracted pneumonia and died 
suddenly on December 29th from one of its 
complications which had made an operation 
necessary. 

At the time of the farewell dinner in New 
York in 1905, Dr. Osier confessed under the 
emotion of his reply to the tribute that had 
been paid him, that to few men had happi- 
ness come in so many forms as it had come 
to him; that his three personal ideals had 
been, to do the day's work well, to act the 
Golden Rule in so far as in him lay, and 
lastly to cultivate such a measure of equa- 
nimity as would enable him to bear success 
with humility, the affection of his friends 
without pride, and to be ready when the 
day of sorrow and grief came to meet it 
with the courage befitting a man. 



During these last two years, though he 
must have felt at times, as did his anxious 
friends, that possibly his span was run, his 
spirit was unflagging. His son, though essen- 
tially an out-of-doors boy, through living 
in an atmosphere of books acquired biblio- 
philic tastes of his own and had formed, like 
Harry Widener at Harvard and Alexander 
Cochrane at Yale a valuable collection of 
imprints of the Tudor and Stewart periods. 
To this collection, Sir William subsequently 
made many additions from his own care- 
fully chosen books and manuscripts. He 
and Lady Osier presented the collection to 
the Johns Hopkins undergraduates as a 
memorial to their son, to become something 
like the Elizabethan Club at Yale, a rallying 
point for young college men with literary 
and bookloving tendencies. He worked, too, 
at every odd moment to complete, so far as 
possible, the unique catalogue of his own 
lifetime collection- of treasures relating to 
the history and literature of medicine, rang- 
ing from a medical tablet from Sardanapolis 
through a series of priceless manuscripts 
and incunabulas to the essential contribu- 
tions to medicine in their originals of our 
own time. 

This incomparable collection with its 
elaborate catalogue, which is not a mere 
enumeration of volumes but is largely bio- 
graphical, indeed autobiographical in char- 
acter, is destined for the library of McGill, 
where he held his first chair in medicine. 
Sir William as may not be generally known 
had lately been offered but had refused the 
position as the head of that great Canadian 
university. He also received a year ago the 
amazing offer from both political parties 
that he stand as fusion candidate for the 
Oxford seat in Parliament, but refused on 
the ground that it should in justice be 
offered to Asquith. 

As President of the Classical Association, 
one of his most notable and, so far as I 
know, his last address, on "The Old Hu- 
manities and the New Sciences" was given 






William Osler, The Man 



167 



before that body in Oxford, May 16th, 1919. 
That a scientist and physician should be- 
come president of the most eminent group 
of British scholars, whose aim is to "pro- 
mote the development and maintain the 
well-being of classical studies" would seem 
incongruous did one not know the man 
whose Greek Testament always stood by 
the "Religio Medici" at his bedside. Dis- 
claiming that he had " ever by pen or tongue 
suggested the possession of even the tradi- 
tional small Latin and less Greek," in this 
remarkable address given in his most bril- 
liant style he makes a plea for no human 
letters without natural science and no 
science without human letters. 

It was inevitable that the address should 
be colored by frequent allusions to the war 
and appeals for individual service to the 
community. Quoting Plato's "Republic" 
that" States are as the men are, they grow 
out of human characters," he concludes 
with this paragraph : 

With the hot blasts of hate still on our cheeks, 
it may seem a mockery to speak of this as the 
saving asset in our future; but is it not the very 
marrow of the teaching in which we have been 
brought up? At last the gospel of the right to live, 
and the right to live healthy, happy lives, has 
sunk deep into the hearts of the people; and before 
the war, so great was the work of science in pre- 
venting untimely death that the day of Isaiah 
seemed at hand "when a man's life should be 
more precious than fine gold, even a man than the 
gold of Ophir." There is a sentence in the writings 



of the Father of Medicine upon which all com- 
mentators have lingered, fy yap irapy 0iXav0po>7riJ7, 
irapeo-ri ical ^ikorexvlv — the love of humanity 
associated with the love of his craft! — philan- 
thropia and philotechnia — the joy of working 
joined in each one to a true love of his brother. 
Memorable sentence indeed, in which for the first 
time was coined the magic word philanthropy, 
and conveying the subtle suggestion that perhaps 
in this combination the longings of humanity 
may find their solution, and Wisdom — philosophia 
— at last be justified of her children. 

Two of Osier's lay sermons to students 
have been published, in which his own life 
habits are more or less reflected. In one of 
them given at Yale where he was giving the 
Silliman Lectures in 191 3, he offered "his 
fellow students" a way of life — "a path in 
which the wayfaring man cannot err, a life 
in day-tight compartments, the main busi- 
ness of which is not to see dimly at a 
distance, but to do what lies clearly at 
hand." 

In 191 o "Man's Redemption of Man" 
was delivered at a service for the students 
at the University of Edinburgh. Osier un- 
consciously chose as his text from Isaiah 
what he himself has been to those who knew 
him. 

And a man shall be as an hiding-place 
from the wind, and a covert from the 
tempest; as rivers of water in a dry place; as 
the shadow of a great rock in a weary 
land. 



SIR WILLIAM OSLER, A TRIBUTE 1 
By HOWARD A. KELLY, M.D. 

BALTIMORE, MARYLAND 




HERE clearly existed 
among all who knew 
him well, a wide- 
spread desire, man- 
ifesting itself in many 
circles, to commem- 
orate Sir William 
Osier's seventieth 

birthday in July. It seems well worth while 

to inquire into the reasons for this unwonted 

stir among the brethren of the stethoscope 

and the scalpel. 

I am sure I shall not be dubbed mechant 

if I venture delicately to hint that at least 

a little piquancy is added to the celebration 

of the seven decades, rotund and replete 

with years of splendid activities, by the 

obvious fact that our dear friend has 

cheated his own jesting computation of the 

years of a man's fertility by several lustra; 

and who among his friends are entitled to 

make so merry at this happy birthday 

party as we, his hoary contemporaries, who 

have also escaped the penalty of innocuous 

desuetude? 

Without being minutely analytical, we 

boldly claim that our Osier is some sort of a 

genius, not perhaps a vast scientific genius 

of the laboratory, nor yet a genius through 

the excess of any one predominant quality, 

but rather the possessor of a rare combina- 

1 Editorial Note: The articles by Drs. Howard A. Kelly, John Ruhrah and Fielding H. Garrison, and 
the historical note on page 211 were written prior to Sir William Osier's death on December 29, 19 19. 

168 



tion of gifts, of a mental and spiritual 
endowment and balance which always at- 
tract and inspire men to higher ideals, and 
which recall them to a renewed dedication 
of life and service to more worthy and 
nobler ends. 

Philadelphia lost Osier, I think, because 
the way to preeminent leadership there 
seemed barred, while instinct led him to 
seek the highest office the profession held 
as a gift for the rare man. Baltimore offered 
him scope for the development of all his 
capabilities in the Johns Hopkins Hospital, 
and in the inauguration and untrammeled 
growth of a new medical school on new 
lines; the time for a change was ripe in 
medicine, the field was open, and the man 
arrived to claim the opportunity as his 
right. 

When Osier settled in Baltimore, the 
medical profession was rent with internal 
dissensions fostered by a numerous progeny 
of starveling medical schools, with "pro- 
fessors" who secured the charter in order 
to gain the title, and who took the title in 
the hope that they might thus learn medi- 
cine, — offshoots of one venerable school 
with a noble history, the University of 
Maryland. With this complete disruption 
all progress was stayed and the harmony 
and united effort essential to progress 



Sir William Osler, A Tribute 



169 



seemed impossible; chaos reigned. Osier 
chiefest of all, but to be just, both Osier 
and Welch, and again Hurd and Halsted, 
by virtue of certain high spiritual qualities, 
and with infinite patience, and by con- 
tinually manifesting the interest they one 
and all felt in men in the other schools, as 
well as in our own, gradually drew together 
these discordant elements, and converted 
a hostile community into a big medical 
fraternity and a cooperative workshop. 

The plain lessons of Osier's life are first of 
all, his supreme devotion to the ideals of his 
profession; the cultivation of broad tastes 
in fields contributory to the medical sci- 
ences; a policy of discovering the best in all 
men, and uniting the profession to serve. 
This latter quality was counterbalanced by 
a willingness to enter into a fight for prin- 
ciple when it was vital. 

I might pause to speak of Osier's rare 
books in which I felt a collector's keen 
interest, or of his inspiring relations to his 
students, or again of his numerous original 
medical investigations ; but others are better 
fitted to tread these fields than I. To my 
mind the greatest thing about Osier was 
this spiritual quality on which I love to 
dwell, and without which I think no man is 
ever truly great. In developing this, his 
best and strongest side, he was fortunate 



indeed in finding the one person in the 
world capable of bringing his talents to 
their highest perfection — I refer to Lady 
Osier. I think Sir William himself will 
readily agree that he never would have 
become the man he is without Lady Osier's 
companionship; so close and so perfect has 
been this fortunate union that it is not 
possible to think of one without the other. 
The years are now running into the 
decades and Osier continues to live and 
work among us here in Baltimore in spirit 
as of yore. We have our Phipps Clinic, our 
Laennec Society, our Book and Journal 
Club begotten by him, our Medical and 
our Historical Societies, and our Library, 
all of which he fostered so diligently; here 
too is the resuscitated and vitalized Medical 
Chirurgical Faculty in its splendid new 
quarters, corresponding to the College of 
Physicians of Philadelphia. The core of this 
heart of Baltimore and Maryland medicine 
is Osier Hall with its gallery of past presi- 
dents presided over by Osier at the rostrum 
in paint and in stone. And so in very deed 
and truth Osier, though loaned to our 
British cousins and knighted by the King, 
yet lives and moves and inspires us here, 
and is likely to continue in perpetuity as 
the patron saint of our Maryland medicine, 
and in some degree of the entire country. 



OSLER'S INFLUENCE ON MEDICAL LIBRARIES 
IN THE UNITED STATES 

By JOHN RUHRAH, M.D. 

BALTIMORE, MARYLAND 

"It is hard for me to speak of the value of libraries in terms which would not seem exaggerated. 
Books have been my delight these thirty years, and from them I have received incalculable 
benefits. . . . For the teacher and the worker a great library such as this is indispensable. They 
must know the world's best work and know it at once. . . . For the general practitioner a well 
used library is one of the few correctives of the premature senility which is apt to overtake 
him. Self-centered, self-taught, he leads a solitary life, and unless his everyday experience is 
controlled by careful reading or by the attrition of a medical society it soon ceases to be of 
the slightest value and becomes a mere accretion of isolated facts, without correlation." From 
"Books and Men," Boston Medical and Surgical Journal, 1901. 



IF the name Osier had been left out of 
the title of this paper, those at all 
familiar with American medical libra- 
ries would have been able at once to 
fill the omission. There is none other who 
has had such an universal influence. Scores 
there are and have been who have left an 
imprint on one medical library, and there 
are some whose influence has extended to 
two or three, but Sir William Osier is the 
only one whose magic has touched all. 

From Boston to San Francisco, from 
Montreal to New Orleans, all, in one way 
or another, are witness to his remarkable 
sympathy and interest. Small libraries like 
that of the Luzerne County Medical So- 
ciety at Wilkes-Barre, as well as large ones 
like that of the Surgeon General's Office at 
Washington, bear testimony to his help- 
fulness, both material and spiritual. How 
can one appraise at its full value his in- 
fluence? To estimate it correctly would take 
another and a wiser man; but if one can 
spin a thread on which may be strung some 
of his pearls of thought, and a few from 
others, and so make a sort of rosary with 
which to tell the story, perhaps the reader 
who has not fallen under his spell may be 
made to feel it, and come to know in a way 
what he has missed. 

Those of us who have known and loved 
the man, who have felt the magic of his 



influence, need no reminder of it. A worker 1 
in one of the larger medical libraries wrote : 
"Who can sum up any adequate description 
of the indescribable charm, friendliness and 
interest he has always taken in everything 
medical, and in medical libraries in particu- 
lar? All of his visits to us have been of a 
character to make us feel that our efforts 
are the magnum opus of human endeavor, 
and the small services we have rendered him 
have been so appreciated as to make us feel 
these visits as red-letter days." 

Wherever he happened to be his interest 
in the medical library was paramount. For 
example, whenever he visited the Massachu- 
setts General Hospital we are told that no 
matter how pressing his other duties, he in- 
variably found time to run into the Tread- 
well Library for a few moments, and he fol- 
lowed up his visits with letters and sug- 
gestions to the librarian. This he did for all 
the libraries encountered in his travels. 

There is an active, wide-awake library at 
Wilkes-Barre, Pennsylvania; his interest in 
it has been continuous and most beneficial. 
At the occasion of his last visit there the 
library had been started in a small way. 
His personal remarks, and letters to mem- 
bers interested, have stimulated and sus- 
tained them in their zeal for a real collection 

1 Mrs. Laura E. Smith, Library of the New York 
Academy of Medicine. 



170 



Osler's Influence on Medical Libraries 



171 



of books. Here, again, his interest has mani- 
fested itself in more material ways, and 
these gifts of his mean much, for they help 
others to give. If one far away and de- 
tached can give, why should not those near 
at hand and directly benefited? But let him 
tell you himself about a gentle art : 

"May I say a word on the art of giving? 
The essence is contained in the well- 
known sentence, 'Let every man do 
according as he is disposed in his heart, 



depend — the men of moderate income, 
who have a balance, however small, at 
the end of the year. To devote a fraction 
of this to the needs of the profession by 
which they have lived is, on the lowest 
motives, good policy, on the highest, a 
delightful privilege. 

"Beyond a modest competency the 
sensible doctor does not aspire, but in the 
profession of every state there is a third 
group, composed of a few men, who, dry- 




The Medical Library of McGill University is in this new building. 



not grudgingly or of necessity.' Sub- 
scriptions to a cause which is for the 
benefit of the entire profession should 
truly be given as a man is disposed in his 
heart, not in his pocket, and assuredly 
not of necessity, but as a duty, even as a 
privilege, and as a pleasure. Some of us, 
the younger men, cannot give. The days 
of travail and distress are not yet over, 
and to give would be wrong. It is sufficient 
for such to have the wish to give; the 
elder brothers will bear your share; only 
be sure to foster these generous impulses, 
which are apt to be intense in direct 
proportion to the emptiness of purse. 
"Upon a second group we must chiefly 



nursed by us, sometimes by the public 7 
have become prosperous, perhaps even 
wealthy. Freely they have received, freely 
they should give. It must be acknowl- 
edged, however, that the admonition of 
Sir Thomas Browne, 'Should your riches 
increase, let your mind keep pace with 
them,' is not always regarded by the 
men of this group. We have seen a good 
deal in the papers about the large for- 
tunes left by the doctors who have died 
in the past few years ; but it has not been 
a pleasant feature to note, with scarcely 
an exception, either an entire neglect or 
a very beggarly remembrance of the pro- 
fession in which these men had at any 



t 7 : 



Annals oj Medical History 



rate laid the foundation of their large 
fortunes." 2 

The young man Osier received his medi- 
cal education at McGill University, in 
Montreal, and when his student days were 
over continued his residence there, even- 
tually becoming a member of the faculty. 
Thus it was that the Library of the Medi- 
cal Department of McGill University was 
the first love, due to the subtle charm 



other times things pertaining to medical 
lore. On one occasion, he sent from Italy 
a superb collection of early Venetian dip- 
lomas; on another a lot of votive offerings 
from the shrine of ^Esculapius. Various 
libraries shared in these ex votos. Dr. Casey 
Wood, of Chicago, once crossed the ocean 
on the same steamship with Osier, and the 
splendid collection of books relating to 
ophthalmology that now grace the shelves 
at McGill was the result. Here as elsewhere 




The reading room 

of youth and propinquity, and it is whis- 
pered that in spite of many favors in 
the past it is to be the recipient of more. 
Here the student Osier browsed among the 
books and laid the foundations that served 
so well in after years. Later on the Library 
was his hobby, and although never one of 
the Library Committee, his wishes were 
always carried out. His contributions were 
numerous — books of all kinds, on the fly 
leaves of which will be found annotations 
about the author in his own handwriting. 
Sometimes a check for a hundred dollars 
accompanied a letter of encouragement; at 

2 "The Functions of a State Faculty," Maryland 
M. J., 1897. 



at McGill University. 

he gave many rare and valuable copies of 
the old masters of medicine. It is related 
that a friend once saw him emerging from 
an Edinburgh bookshop. In his arms he 
clasped a large volume and his face wore 
that peculiar expression of mingled pride 
of possession and happiness common to 
collectors who are rejoicing in une trouvaille. 
This "find" was the first edition of Andreas 
Vesalius, printed by Oporinus in 1543, and 
bearing the colophon, familiar to book 
lovers, of a semi-nude man, astride a 
swimming dolphin. The man is crowned 
with a wreath and is playing a harp in most 
animated fashion. This volume is illustrated 
with woodcuts of such quality that in their 



Osler's Influence on Medical Libraries 



173 



day they were ascribed to Titian. It went 
to McGill, but later, when he replaced it 
by another, was sent to the Library of the 
New York Academy of Medicine. 

The library in San Francisco is grateful 
to Osier for many favors, and after the fire 
in 1906 he got together a number of books 
which were later sent to the San Francisco 
County Society. With these he sent an 
engraving of Servetus and a copy of his 
monograph on this worthy medical martyr. 

Even in Denver Osier's influence was 
felt, though here, apart form copies of 
reprints, it was more his kindly interest than 
anything else, but perhaps more than this 
was his interest in a little publication edited 
by Dr. C. D. Spivak, called Medical Libra- 
ries, the first attempt at a publication 
devoted entirely to this subject in this coun- 
try. Continued from 1898 to 1903, this little 
publication was aided by his financial con- 
tributions and by his securing new sub- 
scribers. This publication is practically 
represented now by the Bulletin of the 
Medical Library Association. 

His experience with the Boston Medical 
Library began early, as he says: 

"In the first place I have a feeling of 
lively gratitude towards this library. In 
1876 as a youngster interested in certain 
clinical subjects to which I could find no 
reference in our Library at McGill, I 
came to Boston, and here I found what 
I wanted, and I found moreover a cordial 
welcome and many friends. It was a 
small matter I had in hand but I wished 
to make it as complete as possible, and 
I have always felt that this Library 
helped me to a good start." 3 

From this time on he was a constant and 
helpful friend. His interest has not been 
unappreciated, for he was the first to be 
made an Honorary Member of the Library, 
in 191 1, and is at present the only one living. 

3 "Books and Men," Boston Medical Library, 
Aequanimitas, 1901. 



When the Library was moved to its present 
building (190 1), he was one of the principal 
speakers at the dedication exercises. His 
"Books and Men," delivered on that occa- 
sion, is now familiar to all interested in 
medical libraries. In the same year, he 




The Boston Medical Library. At the dedication Osier 
delivered one of the addresses. 

read there one of his delightful biographical 
papers, the one on Linacre. As at the Sur- 
geon General's Library later, he was here a 
great advocate of getting the rare and 
interesting volumes out of their hiding 
places in the mouldering dust of the stacks 
into the light of day. How practical he was 
about it! He gave two hundred dollars 
with which to purchase show cases for the 
main reading room in which are displayed 
some of the treasures of the Library. It may 
not be amiss to note that this money was 
the major part of his honorarium for deliver- 
ing the IngersoII lecture on "Science and 
Immortality." 

Not alone this, but numerous other gifts 
of rare and useful volumes are available 
through his generosity. The medical lib- 
raries, even during the war, with all its 



174 



Annals oj Medical History 



sorrows for him, have seen a continuance 
of his gifts, of his messages of inquiry and 
greeting. 

On leaving Montreal Osier went to 
Philadelphia, and on January 7, 1885, was 
elected a Fellow of the College of Physicians 
of that city. A year later, on January 6, 
1 886, he was made a member of its Library 
Committee and served in that capacity 
until the end of 1888, when he left Phila- 
delphia to become the Professor of Medicine 
in Johns Hopkins Medical School. Mr. 
Charles Perry Fisher says: 

"Dr. Osier took an active interest in 
the affairs of the Library and with his 
exceptional personality and rare charm 
that nature is mighty chary in bestowing, 
coupled with an open generosity, was 
of the greatest service, and it was with 
deep regret that we saw him go; but his 
interest in the Library and his generous 
spirit has never left us; not a year passes 
that the shelves of the Library are not 
enriched with the gift of some rare vol- 
ume sent with his remembrance." 

It would be neither possible nor profitable 
to enumerate here all of Osier's gifts to the 
various medical libraries; but some idea 
may be had from the following list, which 
represents a few of his donations to the Col- 
lege of Physicians of Philadelphia. Some 
day a complete list should be compiled and 
printed as an example to the rest of us. 

Aldrovandi, U. Serpentium. . . . Bononiae, apud C. 

Ferronium, 1640. 

• 
Allut, P. Etude bibliographique sue Symphorien 

Champier. . . . Lyon, Scheuring, 1859. 
Bourne, H. R. F. Life of John Locke. 2 vols. London, 

King, 1876. 
Browne, Sir T. Pseudodoxia epidemica. . . . London, 

Dod, 1646. 
Browne, Sir T. Religio medici. ill. Argentorati, Spoor, 

1665. 

Religio medici. 10 ed. London, Curll, 

1736. 
Browne, Sir T. The works. . . . ill. port. London, 

Baffet, 1686. 
Fothergill, A. Copy of (his) will. Manuscript. 

Galen, C. Opera omnia. 5 v. Venetiis, Aldus 

1525. (Greek text.) 



Jenner, E. Further observations on the variolae 

vaccinae. . . . London, Low, 1799. 

Redi, F. Osservazioni intorno agli animali viv- 

enti. Firenze, Matini, 1684. 

Sydenham, T. Tractatus de podagra et hydrope. 

London, Kettilby, 1683. 

Tuke, S. Description of "The Retreat," an insti- 

tution near York for insane persons of 
the Society of Friends. York, Alex- 
ander, 1813. 

Whiter, W. Dissertation on the disorder of death 

. . . London, Hayes, 1819. 

Wotton, E. De differentiis animalibus Iibri. . . . 

Lutetiae Parisiorum, Vascosanus, 1552. 

When we come to Baltimore, we feel 
more sure of our ground. We know so well 
what his influence meant. Miss Marcia C. 
Noyes has written a sympathetic account of 
his influence on the Library of the Medical 




The building used for the Library of the Medical and 

Chirurgical Faculty of Maryland, Baltimore, before the 

new building was undertaken. 



Osler's Influence on Medical Libraries 



175 



and Chirugical Faculty of Maryland and on 
the Society itself. This old library, one of the 
oldest in the United States, was founded in 
1830, and was buffeted about from place to 
place until 1881 found it housed in the 
basement of the old Maryland Historical 
Building, on St. Paul Street. It did not take 
Osier long after he came to Baltimore, in 
1889, to become intimately associated with 
the Maryland Library. In 1892 he was made 
a member of the Library Committee and 
served until he left for Oxford in 1905. Al- 
though never chairman, he was the influen- 
tial member who conceived and carried out 
innumerable plans for betterment. Of all this 
he was to say later: 

"Unlike other state organizations, this 
faculty has in its Library an important 
educational function. It was a singularly 
judicious action on the part of the men 
who controlled this institution (in the 
thirties), to begin a collection of books. 
They knew the true gauge of a profes- 
sion's standing, not the number of its 
schools, not the length of the roll of stu- 
dents, not the material wealth of the 
physicians; these are as dross and slag, 
chaff and dust, in estimating the true 
worth of a profession. Books are tools, 
doctors are craftsmen, and so truly as one 
can measure the development of any par- 
ticular handicraft by the variety and com- 
plexity of its tools, so we have no better 
means of judging the intelligence of a pro- 
fession than by its general collection of 
books. A physician who does not use 
books and journals, who does not need a 
library, who does not read one or two of 
the best weeklies and monthlies, soon 
sinks to the level of the cross-counter pre- 
scribe^ and not alone in practice, but in 
those mercenary feelings and habits which 
characterize a trade." 4 

4 "The Functions of a State Faculty," Maryland 
M. J. 1897. 



The Library of the Faculty was an in- 
tegral part of an organization which had 
played an important part in the medical life 
of Maryland. It had had various periods of 
lethargy, and like the Beauty of the fairy 
tale it was awaiting a Prince Charming. It 
was not dead, not moribund, but asleep; 
and Osier succeeded in waking it. In 1895, 



LIBRARY 

OFTHE MEDICAL AND wCrllRURCICAL FACULTY 

OF THE STATE^'^SfcH-j^TbF MARYLAND 




The book plate of the Osier Fund, designed by 
Dr. Max Broedel. 

it was moved to a building at 847 North 
Eutaw Street (Hamilton Terrace) and in 
the following year the need of a well trained 
librarian was so apparent that Osier himself 
saw to it that the present librarian, Miss 
Noyes, was employed. 

The Library, when Osier found it, was a 
collection of a few thousand medical books, 
mostly old, and some journals. When he left 
us, in 1905, there were 14,590 volumes, and 
it has grown rapidly ever since. Through his 
influence it acquired its own building, and 
after he left in 1909 it was moved once 
more to the comfortable, specially built 



176 



Annals 0/ Medical History 



library building at 121 1 Cathedral Street. 
This new building was directly due to the 
cast mantle of the "Chief." After his 
departure, a project was on foot to buy 
his house at 1 West Franklin Street and use 
it for a memorial and library building. A 
considerable fund resulted, but subsequent- 
ly the plan was changed and the money 
turned over to the Building Committee of 
the Faculty. 

Among the other things Osier was influ- 
ential in founding was the Charles Frick 
section of the Library, which was made 
possible through the generosity of Messrs. 
William F. and Frank Frick, and which 
has been greatly helped since by Mrs. Henry 
Barton Jacobs, nee Frick, and Mr. James 
Swan Frick, as well as by Sir William him- 
self. In his presidential address, "The Func- 
tions of a State Faculty," he said : 

"I envy Charles Frick the good fortune 
to go down to the future generations in 
this faculty with his name linked to an 
important section of our Library. Post- 
humously and by proxy, as it were, thus 
to carry on, though dead, the work he was 
interested in while living, is the nearest 
approach a man can make to cheating the 
great enemy, and in Charles Frick's case 
it is in a measure a compensation for the 
untimeliness of his taking off. It is pro- 
posed to make the Frick Library the 
strictly medical section, in contradistinc- 
tion to general surgery, and obstetrics 
and gynecology. How suitable it would be 
to connect also these departments with 
other names of men who have won suffi- 
cient recognition. Than this there is no 
more appropriate way to perpetuate an 
honored name in our ranks." 

How gratifying it must be for him to know 
that his name is now forever linked with the 
Faculty Library. In the new building, the 
large meeting room is known as Osier Hall. 
There is also an Osier Endowment Fund 
and, perhaps of more importance, an Osier 



Fund for the purchase of books relating to 
medicine. The former was started by Sir 
William years ago, and since he .left his name 
has been added to it. The latter is the resi- 
due, with some additions, of the money 
collected for an Osier Testimonial, and at 
present amounts to an investment of ten 
thousand dollars. It is a great pleasure to 
all his friends to know that in the future his 




The new library building of the Medical and Chirurgical 
Faculty of Maryland at Baltimore. 



name will be constantly before the medical 
profession in connection with the Library 
which was once his hobby, and that future 
generations may know and partake of his 
genial spirit which must of necessity linger 
about the Library as long as it shall last. 

No one realized more than Osier how im- 
portant it was to have the Library well 
financed, and he did a great deal to put 
through many much needed improvements, 
sometimes out of his own pocket, sometimes 
through a generous friend, and constantly 
by appealing to the profession. He believed 



Osler's Influence on Medical Libraries 



177 



the profession should be responsible for the 
Library, but he also knew that the Library- 
had its responsibility, its duty, to the pro- 
fession. And once he voiced this in his 
presidential address : 

"But to maintain a modern medical 
library is a very serious undertaking. So 
extensive has the literature become that 
even well-endowed institutions find it im- 
possible to meet the incessant demands in 
all departments. The Faculty has the 
nucleus of an excellent collection, and 
through the kindness of our friends we 
have been enabled this year to add a long 
list of most valuable journals and many 
complete sets. Within a few years, this 
most valuable section of the Library 
should be greatly enlarged. The true 
worker does not want text-books; he looks 
to journal literature and monographs, 
and the extraordinary development of all 
special departments makes the work of a 
Library Committee very difficult unless 
it has a rich appropriation. In a year or 
two we should be able to give the Com- 
mittee at least double the present al- 
lowance." 6 

Another thought was the Book and Jour- 
nal Club, an excellent idea for an impecuni- 
ous library. With the small dues of five 
dollars a year, a group of over one hundred 
men were induced to join this Club, the 
meetings of which, under Dr. Osier, were a 
delight to all book lovers. Most of the money 
went to the use of the Library, chiefly to 
journal subscriptions, but a portion of it, 
aided very generously from Dr. Osier's own 
purse, went to two or three meetings a year 
at which many of the best medical minds of 
the country contributed to the intellectual 
side; and Dr. Osier's human instincts saw 
to it that the inner man was not forgot. This 
ability to get men out to meetings and to 
get them interested in things was one of his 

6 "The Functions of a State Faculty," Maryland 
M. J., 1897. 



very marked traits, and he succeeded be- 
cause he knew so well how to deal with the 
human being. He knew there were some who 
could be attracted by the way of the esoph- 
agus, and having attended one meeting, 
perhaps for purely physical reasons, would 
also return to the subsequent ones for intel- 
lectual and spiritual benefit. 

Another value of the Library that Osier 
realized fully was its effect on the men who 
make it, the value of striving, of getting to- 
gether for a common purpose. Certainly at 
no time in its history was the Faculty of 
Maryland more alive than in its struggle for 
a new building. This common aim brought 
men together and made them friends and 
brothers^ It was this value and meaning of 
the Library that he sensed in his presiden- 
tial address before the Medical Library 
Association : 

"The organization of a library means 
effort, it means union, it means progress. 
It does good to men who start it, who help 
with money, with time and with the gifts 
of books. It does good to the young men, 
with whom our hopes rest, and a library 
gradually and insensibly moulds the pro- 
fession of a town to a better and higher 
status." 6 

Of Osier's influence on the study of the 
history of medicine it is not for us to speak; 
and yet the impetus that he gave to it 
through his writings, by word of mouth, 
and through his constant interest, has left 
its effect on the collectors of medical books 
in America. First, it stimulated the collec- 
tion of incunabula and of old medical books 
in general; secondly, it led to the purchase of 
books about medical history and bib- 
liography; and lastly, it opened up a new 
field to many students and physicians, so 
that the medical library had a new interest, 
a new meaning for them. So too it increased 
the number of readers and the influence of 

6 "Some Aspects of American Medical Bibliog- 
raphy," Boston M. and S. J., 1902. 



178 



Annals oj Medical History 



the library as a school. He always seemed 
to be saying with Richard de Bury, 

"Aye, come ye hither to this pleasant land." 

On the subject of such study he said: 

"By the historical method alone can 
many problems in medicine be ap- 
proached profitably. For example, the 
student who dates his knowledge of 
of tuberculosis from Koch may have a 
very correct, but a very incomplete, 
appreciation of the subject. Within a 
quarter of a century our libraries will 
have certain alcoves devoted to the 
historical consideration of the great dis- 
eases, which will give to the student that 
mental perspective which is so valuable 
an equipment in life. The past is a good 
nurse, as Lowell remarks, particularly 
for the weanlings of the fold." 7 

Another memorable thing which Dr. 
Osier accomplished was the dragging from 
the shelves and from hidden corners into 
the light of day the great contributions in 
medicine. 

They did not seem like books to him, 
But Heroes, Martyrs, Saints, — themselves 
The things they told of, not mere books 
Ranged grimly on the oaken shelves. 

This has been commented upon above, 
but one cannot refrain from quoting his 
own words on the subject: 

"I should like to see in each library a 
select company of the Immortals set apart 
for special adoration. Each country might 
have its representatives in a sort of 
alcove of Fame, in which the great medi- 
cal classics were gathered. Not necessarily 
books, more often the epoch-making con- 
tributions to be found in ephemeral 
journals. It is too early, perhaps, to make 
a selection of American medical classics, 
but it might be worth while to gather 
suffrages in regard to the contributions 

7 "Books and Men," Boston M. and S. J., 1901. 



which ought to be placed upon our Roll 
of Honour." 8 

In Osier Hall there is a case containing 
Osier's own writings. To-day these are 
highly prized, to-morrow this case and its 
contents will be numbered amongst our 
most precious possessions. These books and 
essays contain so much of his spirit, hold 
such wise counsels and such high ideals, 
that from them may be garnered a store of 
wisdom sufficient to last the moderate life 
time of the average physician. 

Enough! Mere words can never tell 
The influence of the grateful spell 
Which seems among these books to dwell. 

The Library at Johns Hopkins Hospital 
was started about the same time as the 
Hospital (1887), and room was made for it 
in the administration building. Looking 
backward, it seems strange that Billings 
should have made such inadequate pro- 
vision as to space, but this is to be remedied 
in a splendid new building, the gift of an 
anonymous donor. This little library had 
wise heads to start it, but no one took a 
greater part than Osier. He donated much 
and sought out material for it when abroad, 
and all accessions were gone over from 
week to week. He not only used the Library 
himself, but made his students use it, giving 
them references to journal articles or mono- 
graphs and teaching them to go to original 
sources for their information. He also 
insisted on consulting the world's literature, 
not only American or English writings, 
but French and German as well, or even 
articles in other languages, if the student's 
linguistic ability permitted. He was instru- 
mental in getting various gifts, notably 
the Marburg collection, a set of older books 
on medicine which he discovered in his 
European wanderings and which he induced 
Mr. William A. Marburg to present to the 
Library. 

8 "Books and Men," Boston Medical Library, 
1 901. 



Osler's Influence on Medical Libraries 



179 



In Toronto the library was a matter of 
keen interest to him from the formation of 
the Ontario Medical Library Association 
in 1887. He gave a large number of books, 
including some old rare items and certain 
incunabula, and also established a fund in 
honor of his old teacher, Dr. James Bovell, 
to whom in part his text book on medicine 
is inscribed. The interest of this fund is 
used to purchase books on medicine, phys- 
iology or pathology. The older library has 
been merged with that of the Academy of 
Medicine and to this Osier has made a 
number of other gifts of money. 

Just how much Dr. Osier had to do with 
the actual founding of the Medical Library 
Association, which started in May, 1898, 
originally with the name of "The Associa- 
tion of Medical Librarians," it has not been 
possible to ascertain. One suspects a great 
deal, although Dr. George M. Gould has 
generally been given the credit for it, and as 
far as putting the actual machinery of the 
organization into action and for helping it 
in its earlier years, deserves it. The idea origi- 
nated with Miss M. R. Charlton, at that 
time librarian at McGill, and the first 
secretary of the Association. This Associa- 
tion was started for the purpose of fostering 
medical libraries, and the exchange of 
medical literature among them, as well as 
for having annual meetings at which the 
medical librarians could exchange views. 
Dr. Osier was president from 1901 to 1904, 
and gave the Association the benefit of his 
inspiration and experience. He attended and 
addressed the meetings and furthered the 
work in every way. On October first, 1901, 
he sent an appeal to the medical profession, 
an appeal which may be echoed to-day: 

"I write to ask your active cooperation 
in the work of this Association which was 
organized three years ago with the object 
of promoting the interests of medical 
libraries in the United States and abroad. 
We have established an exchange or 



clearing house from which libraries may 
fill out files or periodicals and obtain 
books wanted. Through it they may also 
dispose of duplicates which are of great 
value to libraries just forming. 

"So far as libraries are concerned the 
work we do is largely gratuitous, each 
receiving several times over the value of 
their yearly dues. Thirty-five libraries 
have joined the Association. 

"You can help us — (first) by joining 
the Association and contributing your 
annual subscription of $5.00. (Second) by 
sending old medical works and files of the 
more important journals. On account of 
limited space, no shipment of books 
should be made until notification is 
received from the manager of the Ex- 
change. 

Faithfully yours, 

Wm. Osler, 
President. 
Miss M. C. Notes, 

Manager of the Exchange, 
Baltimore, Maryland. 
(To whom subscriptions may be sent.) 

Sir William Osier is now an honorary 
member of this association, and still from 
time to time sends it words of cheer and 
encouragement. His lively interest in it 
meant much in keeping it going during its 
early years, until now it seems able to walk 
alone. His last visit, during the meeting in 
the Blue Room of the New Willard Hotel, 
Washington, D. G, in 1914, is memorable 
to those who were present. 

The Library of the Surgeon General's 
Office, in Washington, the greatest medical 
library in the world, naturally found a 
warm place in Osier's heart. As a reader and 
borrower of books he appreciated what a 
treasure house it was. Let him tell in his 
own words how he began to use the Li- 
brary: 

"In 1 88 1 I paid my first visit to the 
great Library of the Surgeon General's 



i8o 



Annals oj Medical History 



Office, Washington, to look up the lit- 
erature of echinococcus disease in Am- 
erica, a subject in which I had become 
interested. At that date the Library had 
not yet moved from the old Pension 
office, and the books had far outgrown 
the capacity of the building. It was my 
first introduction to Dr. John S. Billings, 
at present the head of the Public Library, 
New York, to whose energy and perse- 
verance the profession of the United 
States is indebted for one of the greatest 
collections of medical works in the world. 
He handed me over to the care of an 
elderly gentleman, who very quickly put 
at my disposal the resources of the Lib- 
rary, and for two days did everything in 
his power to further my wishes. This was 
the beginning of a warm friendship with 
Dr. Robert Fletcher, and during the 
thirty years which have since passed I 
always found him a kindly, wise, and 
generous adviser in all matters relating 
to medical bibliography. Probably few 
men in the profession owe a deeper debt 
of gratitude to the Surgeon General's 
Library than I. Not only did I enjoy 
the friendship of the officials of all 
grades, but from the Library itself, and 
from its two great publications — the Index 
Catalogue and the Index Medicus — I 
have had constant help in my literary 
work. Among the many congratulations 
I received last year on the occasion of my 
baronetcy, none touched me more than a 
round-robin sent from the staff of the 
Museum and the Library." 9 

"Any time during the past twenty-five 
years special visitors to the great medical 
library in Washington have been received 
in a room next to that of the principal 
librarian, and have had their wants and 
wishes attended to by a courtly and 
learned man who has just passed away 
in his ninetieth year. Surrounded by 

'"Robert Fletcher," Bristol M.-Cbir. J., Dec- 
ember, 19 12. 



books of reference, volumes of the Index 
Catalogue, tables strewn with proof sheets 
and the newest journals, Dr. Robert 
Fletcher looked like a student of the old 
days. But he was more — he had two 
essential qualities of a great librarian — 
kindliness of manner, and a genuine 
interest in books. With Dr. John Billings, 
and the successive Surgeons General, 
he has had an important share in two of 
the greatest bibliographical works of 
modern times, the Index Catalogue, and 
the Index Medicus." 10 

Dr. Garrison speaks thus of the later 
relation : 

"Since the deaths of Dr. Fletcher anc 
Dr. Billings, Sir William Osier has con- 
tinued his friendly relation with the 
Surgeon General's Library, always visit- 
ing the establishment and looking uj 
members of its staff whenever he was ir 
Washington for any length of time. He 
has made many personal gifts to the col- 
lections, and his kindly interest has beer 
manifested by wise counsel and througr 
the routine correspondence which he has 
always maintained with the successive 
Librarians and some of us of the staff. 
It was Osier who suggested to Colonel 
McCaw that the unique collection of med- 
ical classics buried in the alcoves of the 
Library be brought together, preserved 
and protected under glass. Following his 
suggestion this was done, and a catalogue 
of the historical collection was prepared 
and published in Volume xvii of the 
second series of the Index Catalogue. In 
earlier days, the Association of American 
Physicians frequently held its annual 
meetings in the Library Hall and on these 
occasions, those of us who were shut up in 
the confinements of official routine en- 
joyed the rare privilege of hearing Sir 
William speak. The most memorable oc- 

10 "Robert Fletcher," Canadian M. Assc. J., 
N. S. 3, 1913, p. 227. 



Osler's Influence on Medical Libraries 



181 



casion of this kind was at the closing 
exercises of the Army Medical School on 
February 28, 1894, at which he delivered 
his stirring address to the graduates on 
William Beaumont. When he received his 
baronetcy, a round robin of congratula- 
tion, signed by the entire Library force 
was sent him, as he records. He has always 
been regarded as one of the best friends 
the Library has ever had, and for myself, 
the stimulation of his generous encourage- 
ment and the sense of his personality, 
across the sea, has been the finest thing of 
the kind that I have experienced in life." 

Osier knew and praised the inestimable 
value of the Index Catalogue and the Index 
Medicus, for which the world is indebted to 
Billings and Fletcher and, at this later day, 
to the untiring efforts of Garrison. A silent 
tribute is due these men whenever we think 
of these great works, and even the merest 
tyro in medical bibliography finds occasion 
to call the editors blessed. 

" I need not refer in this audience to the 
use of the Index Catalogue in library 
work; it is also of incalculable value to 
anyone interested in books. Let me give 
an everyday illustration. From the library 
of my friend, the late Dr. Rush Huide- 
koper, was sent to me a set of very choice 
old tomes, among which was a handsome 
folio of the works of du Laurens, a six- 
teenth-century physician. I had never 
heard of him, but was very much inter- 
ested in some of his medical dissertations. 
In a few moments from the Index Cata- 
logue the whole bibliography of the man 
was before me, the dates of his birth and 
death, the source of his bibliography, and 
where to look for his portrait. It is im- 
possible to overestimate the boon which 
this work is to book lovers." 11 

This respect for the past, and for the 
masters of medicine, is an essential trait of 

11 "Some Aspects of American Medical Bibliog- 
raphy," Boston M. and S. J., 1902. 



Osier, and he has imparted much of the 
same spirit to his students and associates. 
No one has deplored more the lack of appre- 
ciation of those who have preceded us. 

"Of the altruistic instincts veneration 
is not the most highly developed at the 
present day; but I hold strongly with the 
statement that it is a sign of a dry old 
age when the great men of the past are 
held in light esteem." 12 

For the book lover, the bibliomaniac, he 
has had the affection of a brother. There 
certainly were but few of any prominence 
that were not his warm friends, and he did 
much to induce them to make a practical 
use of their predilection and knowledge. He 
appraises them in no uncertain terms: 

"The men I speak of (bibliomaniacs) 
keep alive in us an interest in the great 
men of the past, and not alone in their 
works, which they cherish, but in their 
lives, which they emulate. They would re- 
mind us continually that in the records of 
no other profession is there to be found so 
large a number of men who have com- 
bined intellectual preeminence with no- 
bility of character." 13 

An example, to cite but one, was the case 
of the scholarly Cordell, for years an ama- 
teur of the history of medicine, particularly 
that of Maryland. Under the genial patron- 
age of Osier this talented worker gathered 
his forces and his notes and brought out the 
Medical Annals of Maryland, one of the 
best pieces of medico-historical work pro- 
duced in this country. 

In this connection, it is interesting to note 
that Osier, while a book lover, a biblio- 
maniac if you will, was singularly well 
poised in that he not only knew the value of 
books and libraries, but their place as well. 

u "The Functions of a State Faculty," Maryland 
M. J., 1897. 

13 "Books and Men," Boston M. and S. J., 1901. 



1 82 



Annals of Medical History 



For the man so intoxicated with learning 
that his powers of action were paralyzed he 
had the greatest sympathy. It has been said 
of a physician, since dead, that he was suc- 
ceeding very well until one of his friends 
gave him a microscope. Ever after histologic 
study proved his undoing. In like manner, 
many a man has been ruined by browsing in 
a library. Of this he once remarked : 

"Curiously enough, the student prac- 
titioner may find studiousness a stum- 
bling-block in his career. A bookish man 
may never succeed; deep- versed in books, 
he may not be able to use his knowledge 
to practical effect; or, more likely, his 
failure is not because he has studied books 
much, but because he has not studied men 
more. He has never got over that shyness, 
that diffidence, against which I have 
warned you. I have known instances in 
which this malady has been incurable; in 
others I have known a cure effected not 
by the public, but by the man's pro- 
fessional brethren, who, appreciating his 
worth, have insisted upon utilizing his 
mental treasures." 14 

On the other hand, no one has had a live- 
lier appreciation of the dangers of ignorance. 
No one in our time has done more to lead 
the doctor to the library. All that is new 
may be found there if one will but take the 
trouble to find it out. 

"It is astonishing with how little read- 
ing a doctor can practice medicine, but 
it is not astonishing how badly he may 
do it. Not three months ago a physician 
living within an hour's ride of the Surgeon 
General's Library brought to me his little 
girl aged twelve. The diagnosis of infan- 
tile myxedema required only a half- 
glance. In placid contentment he had 
been practising twenty years in 'Sleepy 
Hollow,' and not even when his own 
flesh and blood was touched did he rouse 



from an apathy deep as Rip Van Winkle's 
sleep. In reply to questions: No, he had 
never seen anything in the journals 
about the thyroid gland; he had seen no 
pictures of cretinism or myxedema; in 
fact, his mind was a blank on the whole 
subject. He had not been a reader, he 
said, but he was a practical man with 
very little time." 18 

What has been Osier's influence on 
American medical libraries? This question 
is in a measure answered above and chiefly 
in his own words. He has a keen apprecia- 
tion of the value of medical books, as 
summed up in that wonderful epigram: 
"To study the phenomena of disease 
without books is to sail an uncharted sea, 
while to study books without patients is -not 
to go to sea at all." In addition to this, he 
has appreciated medical libraries at their 
full value, not only for himself, but for 
others. This he taught to his students and 
to the profession. He knew and emphasized 
the use of the recent journals and mono- 
graphs, the necessity for knowing the latest 
and best, and pleaded, and not in vain, for 
the historical method of approach, and 
pointed out the impossibility of clear vision 
without it. Then, too, he did much to 
encourage the study of the lives of the 
masters : a major part of recent biographical 
sketches of medical worthies is due directly 
or indirectly to his influence. He taught us 
not only to study the great teachers of other 
days, but to accord them reverence and 
their due meed of honor. To drag the 
treasures of the bookshelves into the open 
and make them mean something is another 
lesson he has taught. This lesson has fallen 
largely on barren ground, although there is 
hope in the future. 

He has taught the art of giving prac- 
tically; he not only gave himself, but led 
others to do likewise, not as a necessity but 



14 "The Student Life," Med. News, N. Y., 1905. 



16 "Books and Men," Boston M. and S. J., igox. 



Ariphron's Hymn to Health 183 

as a privilege. Witness the Frick, the Mar- This intangible something, which defies 

burg, the Casey Wood contributions, to description or analysis, he possesses in 

mention only three. generous measure; this Oslerian spirit will 

He knew that a library must be financed, long pervade all the libraries with which 

and here again he gave, led others to give he has been personally associated, 

and used such delightful methods of raising His reward is to have lived to see the seed 

money as the Book and Journal Club. He which he planted grow and mature, to have 

did much to do away with the old-fashioned as his the love, esteem and gratitude of 

librarian and encouraged the helpful, cheer- thousands of students and friends, and 

ful variety. He made the librarians feel that among these there are none more grateful, 

their work was of great importance and did more appreciative, than the workers in the 

much to develop the esprit de corps which medical libraries of this country. One can 

the Medical Library Association has gone perhaps best summarize in the words of 

on fostering. Shattuck: "There is no medical man of my 

His chief influence, however, is that he time, and there have been few in any other 

has imparted something of his spiritual time, who has exerted so wide spread and 

quality to those about him and to those so sweetly wholesome an influence as has 

with whom he came in occasional contact. he." 

ARIPHRON'S HYMN TO HEALTH 1 

O holiest Health all other gods excelling, 
May I be ever blest 
With thy kind favour and for all the rest 
Of life, I pray thee ne'er desert my dwelling: 
For if riches pleasure bring, 
Or the power of a king, 
Or children smiling round the board 
Or partner honoured and adored, 

Or any other Joy 
Which the all bounteous gods employ 
To raise the hearts of men 
Consoling them for long laborious pain; 
All their chief brightness owe, kind Health, 
to you; 
You are the Graces' spring; 
'Tis you the only real bliss can bring, 
And no man's blest when you are not in 
view. 

C. D. Yonge, B.A. 

There are two English versions of Ariphron's Paean pr Ode (Fourth Century B. C.) both given 
in the Bonn translation of "Athenaeus." "Yonge's is nearer to the original in metre (dartylo- 
trochaic) but less liberal than Sanford's." (Withington). The Greek exists also on a ston«! 
inscription reverenced at Casel. 

1 This Greek poem with its accompanying note was forwarded to the Annals 
of Medical History by Sir William Osier. 



SIR WILLIAM OSLER'S CONTRIBUTIONS TO 
MEDICAL LITERATURE 

By FIELDING H. GARRISON, M.D. 

WASHINGTON, D. C. 



A FEW months ago, the eminent 
engraver who made the portrait 
of Sir William Osier for the Anni- 
versary Volumes 1 requested the 
loan of a few photographs and collateral 
human documents in aid of completing the 
picture which he had to work out on the 
steel plates, an ocean's width from his sub- 
ject. On reading a few bits from Osier's 
writings, he expressed what seemed but 
natural and inevitable enthusiasm for the 
charm of style, the fine humanism which 
enabled him so much the better to sense the 
character and personality of his distant and 
invisible sitter. The anecdote is apposite. 
Were Osier's essays as widely known among 
the cultivated laity as among our profes- 
sion, they would be read and re-read with 
the same pleasure and edification which we 
derive from the purely literary performances 
of Holmes and Weir Mitchell. As the admir- 
able editorial in the Journal of the American 
Medical Association for July 12 (Osier's 
birthday) has expressed it, his essays "be- 
long, many of them, more to the permanent 
'literature of power' than to the short- 
lived 'literature of knowledge. ' " What is 
the 'literature of power'? Is it not the 
literature which helps us to live out our 
brief lives here upon earth in a cheerful, de- 
cent, independent, equable self-respecting 
manner; the literature which (as Matthew 
Arnold said of all creative and imaginative 
literature) is essentially a "criticism of 
life," the literature which recognizes that 
conduct (say the conduct of a medical prac- 
tice) is "three-fourths of human life"? To 
such literature, this great physician has 
indeed been a unique and remarkable con- 
tributor. Through his broad culture, his 

1 Steel engraving, made by Mr. G. F. C. Smillie, 
Washington, D. C. 



deep knowledge of his subject, his keen 
vision, the extent of his experience with 
human nature, his warmth of sympathy and 
his innate geniality and kindliness of dis- 
position, he is the essential humanist of the 
medicine of our time, and great will be the 
reward which awaits him among the phy- 
sicians of the future. 

In the first twenty years of his medical 
life (1870-90), Osier was almost exclusively 
occupied with the practice and study of 
clinical medicine, in following up the end- 
results of disease in the dead-house, in 
training young students in the wards and 
at the bedside. With the single exception 
of the memorable valedictory address "AL- 
quanimitas" (University of Pennsylvania, 
1689), there are no purely literary contribu- 
tions in this period. Prior to the apprecia- 
tive address about Weir Mitchell, at the 
presentation of his portrait to the College 
of Physicians (April 22, 1890), all but one 
of the 278 contributions listed in Miss 
Blogg's bibliography of Osier are purely 
scientific contributions to clinical medicine, 
histology and pathology, each of them none 
the less attractive reading, through the 
clarity of style, the lively humor, and the 
ease and simplicity with which very real 
and living knowledge is conveyed. Even in 
the earliest of these, there are some traces 
of the elevating literary quality, the artist's 
avoidance of the trite cliche, the big human 
oratio directa, adumbrated in Professor 
Gildersleeve's lines — 

"Aseclepius was Apollo's chosen son, 
But to that son he never lent his bow, 
Nor did Hephaestus teach to forge his net; 
Both secrets hath Imperial Osier won. 
His winged words straight to their quarry go, 
All hearts are holden by his meshes yet." 

And beginning m 1891 with the address on 



184 



Osler's Contributions to Medical Literature 



185 



Virchow, what a wonderful and fascinating 
array of essays on medical biography 
and the history of medicine! The great 
work on the "Principles and Practice of 
Medicine" (1892), the most readable and 
informing ever written, took hold with the 
profession immediately through its unaffect- 
ed charm of style, the wealth of literary and 
scientific allusion, and the clear, terse mode 
of presentation. The burlesque examinations 
on Osier's "Practice," which were published 
at the time, suggested the need of actual 
notes and commentaries for the more recon- 
dite allusions, some of which still have us 
guessing. The value of the literary method, 
as a fillip to the reader's ignorance, and as a 
means of arresting his attention, is equally 
manifest in Osier's very latest contribution, 
his monograph on "The Treatment of 
Disease" in Oxford Medicine (191 9). A few 
paragraphs from this last will serve. They 
are pure Osier, ever the eloquent, witty, 
courageous,.sagacious Osier of the "Practice" : 

"For long centuries disease was be- 
lieved to be the direct outcome of sin, 
'flagellum Dei pro peccatis mundi,' 
to use Cotton Mather's phrase, and 
the treatment was simple — a readjust- 
ment in some way of man's relation with 
the invisible powers, malign or benign, 
which had inflicted the scourge. From 
the thrall of this 'sin and sickness' 
view, man has escaped so far, as no 
longer, at least in Anglo-Saxon com- 
munities, to have a proper saint for each 
infirmity." 

"One special advantage of the skep- 
tical attitude of mind is that a man is 
never vexed to find that after all he 
has been in the wrong. It is an old story 
that a man may practice medicine suc- 
cessfully with a very few drugs." 

"Why, for example, should Y and 
Company write as if they were direc- 
tors of Iargegenito-urinary clinics^_in- 
stead of manufacturing pharmacists? 



It is none of their business what is the 
best treatment for gonorrhea — by what 
possibility could they ever have known 
it, and why should their literature pre- 
tend to the combined wisdom of Neisser 
and Guyon? What right have Z and 
Company to send on a card directions 
for the treatment of anemia, and 
dyspepsia, about which subjects they 
know as much as an unborn babe, and, 
if they stick to their legitimate business, 
about the same opportunity of getting 
information? Far too large a section of 
the treatment of disease is today con- 
trolled by the big manufacturing phar- 
macists, who have enslaved us in a 
plausible, pseudo-science." 

"A Philadelphia friend once jokingly 
defined my practice at the Johns Hop- 
kins Hospital as a mixture of hope and 
nux vomica, and the grain of truth in 
this statement lies in the fact that with 
many hospital patients once we gain 
their confidence and inspire them with 
hope, the battle is won." 

Between the "Practice" (1892) and the 
monograph just quoted from, we find a 
brilliant series of literary contributions fit 
to furnish forth several reputations. First of 
all, the series of biographical essays — 
Charcot (1893), William Beaumont (1894, 
1902), O. W. Holmes (1894), Bassett, the 
Alabama Student (1896), John Keats (1896), 
Thomas Dover (1896), Louis (1897), Will- 
iam Pepper (1899), Elisha Bartlett (1900), 
John Locke (1900), Alfred Stille (1902), 
Richard Morton (1904), Jesse W. Lazear 
(1904), Sir Thomas Browne (1905), Harvey 
(1906), Fracastorius (1906), Linacre (1908), 
John Hewetson (191 o), Servetus (1910), 
Pasteur (191 1), Robert Fletcher (191 2), 
Stensen (191 2), Sir Samuel Wilkes (19 12), 
Gui Patin (191 2), George Bodington (19 12), 
John Caius_(i9i2), Winslow (1913), John 
Shaw. BiIIings^(i9i3),' Nathan Smith (1914), 
Weir Mitchell (1915) and Trudeau (19 15). 



i86 



Annals oj Medical History 



You will sense the breadth of Osier's sym- 
pathies from this calendar of tributes to the 
great and deserving of the profession. Then 
the big humanistic addresses dealing, some- 
times in friendly, hortatory manner, with 
the larger aspects and ethical problems of 
medicine, such as Teaching and Thinking 
(1895), Nurse and Patient (1897), Chauvin- 
ism in Medicine (1902), The Master Word 
(1903), Unity, Peace and Concord (1903), 
The Student Life (1905), The Male Climac- 
teric (1905), The Faith that Heals (19 10), 
Man's Redemption of Man (1911), A Way 
of Life (191 3), Examinations, Examiners 
and Examinees (191 3), Specialism in the 
General Hospital (191 3), Bacilli and Bullets 
(1914), The Medical Clinic (1914), Science 
and War (1915), and the learned Oxford 
address on The Old Humanities and the 
New Science (1919); finally the larger con- 
tributions to the history of medicine such 
as those on Medicine in Plato (1882), British 
Medicine in Greater Britain (1897), Medi- 
cine in the Nineteenth Century (1901), The 
Coming of Books and Men (1901), The Evo- 
lution of Internal Medicine (1907), Age of 
I nternal Medicine in the United States ( 1 9 1 5 ) , 
and the still unpublished Yale Lectures of 
1913, which are an aeroplane panorama of 
the progress of medicine in space and time. 
An outstanding feature of these historical 
studies is the surprising array of new facts 
and new knowledge presented. Americans, 
for instance, should not forget that what we 
know of the actual scientific achievement of 
our colonial and early nineteenth century 
physicians, the things they are remembered 
by today, is largely due to the enthusiastic 
researches of Osier and his students. 

During the war period, Osier has turned 
his attention to medical bibliography and 
medical library problems as evidenced by 
such titles as The Proposed General Cata- 
logue of Incunabula (1914), Early Printed 
Books (19 14), MSS and Books in the 
Bodleian Illustrating the Evolution of Brit- 
ish Surgery (19 14), The Jonathan Hutchison 



Iconography (1915), The Science of Libra- 
rianship (19 17). He is now preparing a 
unique collection of original texts and docu- 
ments relating to the basic discoveries, 
inventions and advances in scientific medi- 
cine and it is the hope and wish of all his 
friends that he will complete the reasoned 
catalogue of this wonderful gathering. Such 
a catalogue will be bibliography in the 
finest sense, a purview of the great land- 
marks of medicine sub quadam specie aeter- 
nitatis. The only thing resembling such 
work might be the great catalogue of the 
medical collections of the Bibliotheque Im- 
periale, usually attributed to Emile Littre 
which Taschereau printed as an impersonal 
public document, under the auspices of the 
third Napoleon, without so much as a men- 
tion of Littre's name. In this work, it will be 
remembered, the medical texts are arranged 
in chronologic order under each subject. 
The main lesson conveyed to our profes- 
sion in the writings of Osier is summed up in 
the title of one of his earliest addresses, "JE- 
quanimitas," the last word of the emperor 
Antoninus Pius, of which a corollary is the 
other Roman device: medium tenuere tutis- 
simum. Keep cool; avoid extremes and ex- 
cesses; don't despair; don't whine and com- 
plain; avoid the anxiety-neurosis; repose 
is better than male hysteria; "the ego dis- 
turbs the cosmos"; "the gods approve the 
depth and not the tumult of the soul"; 
never lose your self-possession; in plain 
English, don't make an ass out of yourself. 
Do not be a petty "have not." Envy is the 
sign of inferiority. The great of old, the 
Homers, Shakespeares, Newtons, Beetho- 
vens, Pasteurs, have not been grabbers but 
givers of the most priceless things we have. 
Do not worry about the future, nor glue 
your eyes to a hypothetical reputation 
which may never come. Let Fate deal the 
cards. Take no thought of the morrow; at- 
tend to the immediate duties and "demands 
of the hour" (Goethe's word). The world is 
from of old, and it will all be the same a 



Osler's Contributions to Medical Literature 



187 



hundred years hence. Avoid controversy; 
live on good terms with your colleagues and 
do not condemn if you can help it. " Silence 
is a powerful weapon." To pursue your own 
course in equanimity, independence, self- 
possession, si jractus illabatur orbis, is the 
surest way to keep fools and rogues at a 
distance, and to can the bore. Victories are 
usually won by the nations and individuals 
who remained sturdily and steadily on their 
own ground and did not make the initial 
offensive — 

."Who bides at home, nor looks abroad, 
Carries the eagles, and masters the sword." 

Needless to say, these are among the perma- 
nent ideals of the Anglo-Saxon race, but few 
have lived up to them as Osier has. There are 
people who have abused him, but he himself 



has cherished ill feelings against no living 
being. A few harmless quips among his in- 
timates, outspoken, vigorous denunciation 
of the evils and follies of the hour, that is the 
sum of his offensive. During the great war, 
whatever his private and personal feelings 
may have been, never once has he taken the 
weak line of decrying the literature, art and 
science of the enemies of his country. And 
such dignified reticence is not either an 
index of rancor or abjection, but of personal 
noblesse and nobility of mind; since to 
jape at the products of mind, of whatever 
origin, is only betise. If one might venture 
to describe Sir William Osier at seventy, 
it would perhaps be in the sentence of 
his beloved Landor: "He never contended 
with a contemporary, but walked alone on 
the far eastern uplands, meditating and 
remembering." 




PRESENTATION TO SIR WILLIAM OSLER, F. R. S., BART. 



ON THE OCCASION OF THE SEVENTIETH ANNIVERSARY OF HIS 
BIRTHDAY AT OXFORD, JULY II, I919 



THERE was a very large gather- 
ing in the Barnes Hall of the 
Royal Society of Medicine 
[London] on Friday July nth, 
1 9 19, to commemorate by the presentation 
of two specially prepared volumes of medi- 
cal and biological essays the arrival of Sir 
William Osier at the age of seventy. The 
volumes contain contributions of about 
150 writers drawn from both sides of the 
Atlantic. 

Professor Sir T. Clifford Allbutt occupied 
the chair and made the presentation. He 
was supported by Col. Sir D'Arcy Power, 
R. A. M. C, Sir Donald MacAIister, Gen- 
eral Birkett, C. A. M. C, Mr. J. Y. W. 
Macalister, Sir Wilmot Herringham and 
Dr. Charles Singer. Among those present 
were Lady Osier, Lady Power, Sir George 
Perley, High Commissioner for Canada, 
Dr. Pasteur, Lieut. General Sir John Good- 
win, Director General Army Medical Ser- 
vice, Sir Bertrand Dawson, Sir David 
Bruce, Lady Strathcona, Sir Anderson 
Critchett, Sir William Hale White, Mrs. 
Charles Singer, Major W. W. Francis, 

C. A. M. C, Sir Archibald Garrod, Mr. 

D. J. Armour, Dr. Archibald Malloch, 
Professor G. Drezer, Prof. Ramsay Wright, 
Mr. R. R. Steele, Dr. E. Ainley Walker, 
Surgeon Vice Admiral Sir Robert Hill, 
Medical Director of the Royal Navy, 
Major General G. la F. Foster, Director 
General Medical Services Canadian Forces, 
Sir G. H. Savage and Sir Walter Fletcher. 

The Chairman: Ladies and gentlemen, 
we are assembled here today to do honour 
to our colleague, Sir William Osier. Unfortu- 
nately, another important meeting has 
clashed with this one, so that several of our 
friends who would willingly have been here, 
are very disappointed at their inability to be 
with us. Among them are Sir Norman 



Moore, Sir Humphrey RoIIeston, Sir Fred- 
erick Mott, and Dr. Raymond Crawfurd. 

Sir William Osier, ladies and gentlemen: 
To me, as one of your oldest friends in time, 
and perhaps the oldest in age, has fallen 
the honour of announcing our celebration 
of your seventieth birthday, one universal 
of many years of supreme service in two 
kindred nations and for the world. The 
last lustrum of your three score-and-ten, if 
now merged in victory, has been a time of 
war and desolation, of broken peoples and 
stricken homes. Yet through this clamour 
and destruction your voice, among the 
voices in the serener air of faith and truth, 
has not failed, nor your labour for the 
sufferings of others grown weary. 

But, while thus we celebrate your leader- 
ship in the relief of sickness and adversity, 
we are far from forgetting the sunnier 
theme, the debt, none the less, which we 
owe to you in other fields of thought. In 
you we see the fruitfulness of the marriage 
of science and letters and the long inheri- 
tance of a culture which, amid the manifold 
forms of life and through many a winter 
and summer, has revived to inspire and 
adorn a civilization which, so lately, has 
narrowly escaped the fury of a barbarian. 

And now I will not avoid a topical allu- 
sion, an allusion to your recent Presidential 
Address to the Classical Association at 
Oxford: an address which, in its various 
learning, its wisdom and its wit, brilliantly 
illustrated this fecundity of letters and 
science, embodied a common spirit of 
science and art, and conferred a distinction 
upon our profession. 

In these volumes, we hope, you will find 
the kind of offering from your fellow 
workers which will please you best: imma- 
terial offerings indeed, but such as may out- 
live a more material gift. As to you we owe 



Presentation to Sir William Osler 



189 



much of the inspiration of these essays, and 
as in many of their subjects you have taken 
a bountiful part, so, by them, we desire to 
give some form to our common interests 
and affections. 

We pray that health and strength may 
long be spared to you, and to her who is 
the partner of your life: and that for many 
years to come you will abide in your place 
as a Nestor of modern Oxford, as a leader 
in the van of medicine, and as an example 
to us all. 

Sir Clifford Allbutt then made the pres- 
entation. 

Sir William Osier: Sir Clifford Allbutt, 
ladies and gentlemen, as the possessor of 
a wild wagging tongue, which has often 
got me into trouble, I thought it would be 
better, on such an occasion, to put down 
what I am going to say. 

Two circumstances deepen the pride a 
man may justly feel at this demonstration of 
affection by his colleagues on both sides of 
the Atlantic — one, that amid so much men- 
tal and physical tribulation my friends 
should have had the courage to undertake 
this heavy task, the other, to receive this 
presbyopic honour at the hands of my 
brother Regius, friend of more than forty 
years. There is no sound more pleasing 
than one's own praises, but surely an 
added pleasure is given to an occasion 
which praises the honourer as much as the 
honoured. To you, Sir, more than to anyone 
in our generation, has been given a rare 
privilege: when young, the old listened to 
you as eagerly as do now when old the 
young. Like Hai ben Zagzan of Avicenna's 
allegory, you have wrought deliverance to 
all who have consorted with you. 

To have enshrined your gracious wishes 
in two goodly volumes appeals strongly to 
one the love of whose life has been given 
equally to books and men. A glance at the 
long list of contributors, so scattered over 
the world, recalls my vagrant career — 
Toronto, Montreal, London, Berlin and 



Vienna as a student: Montreal, Phila- 
delphia, Baltimore and Oxford as a teacher. 
Many cities and many men, truly, with 
Ulysses, I may say "I am part of all that 
I have met." 

Uppermost in my mind are feelings of 
gratitude that my lot has been cast in such 
pleasant places and in such glorious days 
so full of achievement and so full of promise 
for the future. Paraphrasing my life-long 
mentor — Sir Thomas Browne — among mul- 
tiplied acknowledgments I can lift up one 
hand to Heaven that I was born of honest 
parents, that modesty, humility, patience 
and veracity lay in the same egg and came 
into the world with me. To have had a 
happy home, in which unselfishness reigned, 
parents whose self-sacrifice remains a 
blessed memory, with brothers and sisters 
helpful far beyond the usual measure — 
all these make a picture delightful to look 
back upon. Then to have had the benedic- 
tion of friendship follow one like a shadow, 
to have always had the sense of comrade- 
ship in work, without the petty pin-pricks 
of jealousy and controversy, to be able to 
rehearse in the sessions of sweet silent 
thought the experiences of long years with- 
out a single bitter memory — to do this fills 
the heart with gratitude. That three trans- 
plantations have been borne successfully 
is a witness to the brotherly care with 
which you have tended me. Loving our 
profession, and believing ardently in its 
future, I have been content to live in it and 
for it. The moving ambition to become a 
good teacher and a sound clinician was 
fostered by opportunities of exceptional 
character, and any success I may have 
attained must be attributed, in large part, 
to the unceasing kindness of colleagues and 
to a long series of devoted pupils whose 
success in life is my special pride. 

And to a larger circle of men with whom 
my contact has been through the written 
word — general practitioners of the English- 
speaking world — I should like to say how 



190 



Annals oj Medical History 



deeply their loyal support has been appre- 
ciated. 

And if, in this great struggle through 
which we have passed, sorrow came where 
she had not been before, the blow has been 
softened by the loving sympathies of many 
dear friends. And may I add the thanks of 
one who has loved and worked for our 
profession, the sweet influences of whose 
home have been felt by successive genera- 
tions of students? 

To the Committee and Editors I am 
deeply indebted for the trouble they have 
taken in these hard days, and to the pub- 
lisher, Mr. Hoeber, for his really pre-war 
bravery. And our special thanks are due to 
you, dear friends^-and in this I include 
Lady Osier's — you who have graced this 
happy ceremony with your kindly presence. 

Sir D'Arcy Power: Ladies and gentlemen, 
it is my very pleasant duty to close this 
interesting meeting by proposing a vote of 
thanks to Sir Clifford Allbutt for having 
come here this afternoon to preside over us 
and make this presentation. I suppose this 
is the first occasion on which the two Regius 
Professors of the two Universities of Oxford 
and Cambridge have come together for 
such a function. I hope it is a good augury 
for the future. We owe to Sir Clifford 
Allbutt our very best thanks for coming 
to London for this purpose. 

Sir Donald MacAlister: On behalf of those 
who are not members of the Committee, 
for whom Sir D'Arcy Power has spoken, 
I have been asked to support this vote of 



thanks to Sir Clifford Allbutt. The function 
he has carried out is one we all feel grateful 
for. And, more than that, those of us who 
come from Cambridge feel proud of him. 
We were perfectly aware that when the 
Regius Professor of Cambridge undertook 
to make the presentation to the Regius 
Professor of Oxford, it would be done in 
the most perfect possible manner. The — 
to use his own words — variety of learning, 
the wit, the wisdom, and, I may add, the 
deep feeling, which characterised his utter- 
ance in making the presentation to our 
dear friend Osier, fully justified our expec- 
tation and our pride. It was only right that 
Oxford and Cambridge should join in the 
presentation, and that Oxford and Cam- 
bridge should join in thanks to him who 
has taken the chair. 

Sir Clifford Allbutt: Ladies and gentlemen, 
that you should so cordially and kindly 
thank me for taking the chair on this occa- 
sion came to me, when a few minutes ago I 
heard of it, with great surprise. It seems to 
me contrary to what ought to have taken 
place, for it is I who ought to thank you 
for giving me the one great privilege of my 
life, of coming forward on an occasion which 
may, perhaps, be described as unique, to 
voice your feelings in this matter, to be 
your intermediary in this presentation to 
our honoured friend Sir William Osier. It 
is a matter on which I have most cordially 
to thank you, rather than to receive your 
thanks. 

(The proceedings then terminated.) 



* 



ADDITIONS TO THE LIST OF INCUNABULA IN THE LIBRARY 
OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA 



The following are additions to the list of the 
Incunabula in the possession of the Library of the 
College of Physicians of Philadelphia published in 
Vol. II, No. i, pp. 44-78, of the Annals of Medical 
History. Charles Perry Fisher, 

Librarian. 

Aquinas, Thomas. [Commentarius in Iibros 
Aristotelis de anima.] [F.ia:] Incipiunt 
comentaria [sic] gloriosi simi doc- 
to[r]is sancti. Thome de | aquino ordinis 
p[r]edicatoru[m] su | pe[r] Iibris aristotilis 
de anima. | [F.6ib:] Explicit commentum 
Sancti Thome de | aquino o[r]dinis p[r]ed- 
icatofrum] super Iib[r]os | aristotelis de 
anima. Papiae Imp[r]essum per Mar- 
tinufm] de Iaualle de mo[n]ferato. An | no 
christi. M.cccc.Ixxxviij. die ultima men | 
sis setemb[r]is. | [Registrum.] 

[61] ff. F°. Papiae, Martinus de Laval Ie de 

Monferato, 1488. 
[Hain no. 1521.] 

Aristoteles. [De generatione et corrupti- 
ione liber.] [F.ia vacat.F.2a (c.sig.a2):] 
Textus Ar[istoteIis] de generatione [et] cor- 
ruptione cum | expositione omniu[m] ex- 
positio[rum] eius optimi interpetris | 
Egidi.j Romani Feliciter incipit. | [F.32a: 
Explicit expositio Egidii super pri | mum 
Iibrum de generat[i]one Aristotelis. | [F. 
54b:] Explicit textus Aristotelis de gener- 
atione I et corruptione una cum exposi- 
tionibus Egi | dii de roma o[r]dinis her- 
emita[rum]. | *** Impressum patauij.M.- 
CCCC.LXXX. die XXIIIj.feb[r]uarij | 
i[n]genio [et] impensa Joannis gra[n]dis 
herbort [de] silgenstat. | [F.55 vacat.F. 
56a:] Questiones clarissimi philosophi 
Marcilij inguen su | per Iib[r]is de genera- 
tione et co[rr]uptione incipiunt. [F.i24b:] 
Expliciu[n]t q[uesti]o[n]es sup[er] Iib[r]is 
de g[e]n[er]at[i]one et co[r]rupt[i]o[n]e 
Ari. I *** eme[n]date p[er] *** Nicoletu 
[m] vernia [m] theatinu[m] *** Anno 



d[omi]ni. m.cccc.Ixxx.die xxix. feb[r]uarii] 
[Deinde tab.quaestionum et versus de 
emptore et Marsilio. Seq.3 ff. appendix et 
registr.] 

[127] ff. F°. Patavii, Johannes Herbort de 

Seligenstat, 1480. 
[Hain no. 1692.] 

Beroaldus, Philippus. 1 [Annotationes in 
Commentaries Servii in Virgilium.] [F. 
1 a:] Ad magnificum virum Franciscum 
Lasatum | *** Philippi Beroaldi Bono- 
mensis epistola. [F.33a.:] Laus deo. 
[F.33b.] post endecasyllabon ad Iibellum : 
Impressum Bononie per me Henricum de 
I Colonia su[m]ma diligentia [et] cura. 
Anno do- | mini. Mcccclxxxij me[n]sis 
Noue[m]b[r]is. | 

33 ff. 4 . Bononiae, Henricus de Colonia, 1482. 
[Hain no. 2944.] 

[Bound with Plinius, C. S. Epistolarum. *** 
1483.] 

Beroaldus, Philippus. 1 [De felicitate opus- 
culum.] [F.i. tit.:] Philippi Beroaldi de fe 
I Iicitate opusculum. | [F.2. :] AD ILLUS- 
TRUM MARCHIONEM | JACOBUM 
BADENSEM PHI [ LIPPI BEROALDI 
BONO I NIENSIS EPISTOLA. | [F. 
3 vacat. F.5. (c.sig.a i) in rubem:] ORA- 
TIO PHILIPPI BEROALDI BO | NO- 
NIENSIS DE FELICITATE HABI | 
TA IN ENARRATIONE GE | ORGI- 
CON VIRGILII et | COLUMELLAE. 
[F.35a. :] O P VScuIu[m] hoc de felicitate 
Iuculentufm] i[m]presso | ria Platonis de 
Benedictis Bononiae incude egre | giis his 
caracteribus excussum Anno saluttis Mil- 
I Iesimo quadringentesimo nonagesimo 
quinto | Calendis aprilibus lector amplec- 
tere et foue si fe | Iix esse cupis. | REGIS- 
TRUM. I Primo folio continentur Epis- 
tola Deinde | a.b.c.d.omnes sunt quater- 
niones. | [Insign. typ.] PLA. 



191 



192 



Annals oj Medical History 



[35] ff. 12 . Bononiae, Plato de Benedictus, 

1495. 
[Hain-Copinger no. 2969.] 

Hugo Senensis. [Expositio in Iibros tegni 
Galeni.] [F.ia:] Expositio Ugonis Senensis 
super Iib[r]os tegni Galieni. | [F.2a:] § In- 
cipit expositio Clarissimi viri Ugonis 
sene[n]sis super | Iib[r]os tegni Galieni. | 
[F.93b:] Opus imp[r]essum venetiis: man- 
dato et sumptibus Nobilis | viri Domini 
Octauiani Scoti Ciuis Modoetiensis. Un | 
decimo kalendas Julias.i498.per Bonetum 
Loca I tellum Bergomensem. | Registrum 
I *** Finis. I [Insign.typ.] O.S.M. 

[93] ff. F°. Venetiis, Octavianus Scotus per 

Bonetum Locatellum, 1498. 
[Hain no. 9015.] 

Hugo Senesis. [Expositio super primo 
canonsis Avicennae.] [F.ia.tit:] Expositio 
Ugonis Senensis | super p[r]imo Canonis 
Aui I cenne cum questioni | bus eiusdem 
I [F.i 24b:] § Opus imp[r]essum Uenetus 
mandato et expe[n]sis nobilis ] [Uiri D[o- 
mi]ni Octauiani Scoti Ciuis Modoetie- 
[n]sis Qui[n]to | kalendas Maias i498. Per 
Bonetum Locatellum | Bergomensem. | 
Finis. I [F.i 25a:] Registrum. | Finis | [In- 
sign.typ.] O.S.M. 

[125] ff. F°. Venetiis, Octavianus Scotus per 

Bonetum Locatellum, 1498. 
[Hain no. 9017.] 

Hugo Senensis. [Tractatus utilissimus circa 
la conservazione della sanitade.] [F.i (c. 
sig.a) :] Tractatus utiIissi[m]o circa la [con- 
ser]uat[i]o[n]e[de] Iasa[n]ita[de] [com]posto 
p[er] il cla[r]i[ssimi] [et] | excelle[n]ti phil- 
osofo[et] doctore di medici[n]a Me[ss] Ugo 
Be[n]zo. [F.52a (c.sig.g4):] Exactum est 
hoc opus M[edio]I[an]i | cu[r]a diligentia 
Petri de co[r] | neno MedioIane[n]sis.i48i. 
p[r]i I die calendas Junias. *** [F.52b-54a: 
registrum.] 

54 ff. 4 . Mediolani, Petrus de Cornerio, 148 1. 
[Hain no. 9021.] 

Jacobus Forliviensis. [Expositio in 
primum Iibrum canonis Avicennae.] [F.i a. 
tit.:] Expositio Jacobi fo[r]Iiuiensis super 



cano I nis Auicenne cum questionibus 
eiusdem | [F.36 (c.sig.EE6) col. 1. 1. 24:] § 
Scripta Flore[n]tie et [com]pIeta p[er] me 
Ugone[m] Se | ne[n]sem. Anno domi[ni] ab 
i[n]carnat[i]one. i42i. [sic] die. 2. Januarij 
ame[n] | [Tabula. Registrum.] FINIS | 
[Insign.typ.] O.S.M. 

[126], [36] ff. F°. [Venetiis, Octavianus Scotus 

per Bonetum Locatellum, circa 1495.] 
[Hain no. 7245.] 

Moses Maimonides. [Aphorismi medici.] 
[F.i :] Hoc in volumine hec continent[ur]. 
I Apho[r]ismi Rabi moysi. | Apho[r]ismi 
Jo. Damasceni. | Liber secreto[rum] Hip- 
pocratis. | Liber p[ro]nosticationum [Su]- 
m Iuna[m] in si- | gnis et aspectu plane- 
tarum Hipoc. | Liber q[ui] dicit[ur] cap- 
sula eburnea Hipo. | Liber de eleme[n]tis 
siue de humana na | tura Hipocratis. | 
Liber de aere [et] aqua [et] regio[n]ib[us] 
Hip. I Liber de pharmacijs Hipocratis. | 
Liber de insomnijs Hipocratis. | Liber 
zoar de cura Iapidis. | [F. 48a:] [In[sic]- 
p[r]essum est p[r]esens voIumne[m] Vene- 
tijs per.m.Joha[n]- nem hertcog de 
Landoia alumanu[m] Anno iubilei. 1.500. 
I Die vero decimo Januarij. | Laus deo. 
I Registrum. | *** Finis. [Zyl. typ. insign.] 

48 ff. F°. Venetiis, Johannes Hamman de Lando- 

via, 1500. 
[Not in Hain.] 

Petrus de Abano. [Tractatus de remediis 
venenorum.] [F.i a:] Tractat[us] Pe[tri] 
d[e] Abano de remediis uenenofrum] [F. 
32b:] § Finiunt Pe[trus] de Abano remedia 
ueneno[rum]. 

32 ff. 4 . [Romae, circa 1473.] 
[Not in Hain.] 

Plinius, Cajus Secundus. [Epistolarum 
Iibri IX] [F.ia:vacat, manque.F.2a (c. 
sign.a ii):] CAII PLINII SECUNDI 
NOVOCOMENSIS ORATO | RIS FA- 
CUNDISSIMI EPISTOLARUM LIB- 
ER PRI I MUS INCIPIT. I [F.92b:] 
FINIS. Impressum quidem est hoc opus 



Incunabula 



193 



Taruisii per Magistru[m] | Ioann | em 
Vercellium. Anno salutis. Mcccclxxxiii. | 

92 ff. 4 . Tarvisi, Johannes Vercellensis, 1483. 
[Hain no. 131 13.] 

[Contains also Beroaldus, P., Annotationes in 
Commentaries Servii in Virgilium. 1482.] 

Poggius, Joh. Franciscus. [Facetiarum 
Iiber].[F.ia (c.sign.a2.) :] POGII FLOR- 
ENTINI ORATORIS CLARISSIMI 
FACETIARVM LIBER INCIPIT FE- 
LICITER. [F.^ob:] Pogii florentini secre- 
tari apostolici facetfa[rum] liber absolut- 
[us] I e[st] feliciter. Impressum Venetiis 
anno. M.CCCCLXXXVIL Die. X. men- 
sis Aprilis. 

[50] ff. 4 . Venetiis, 1487. 
[Hain no. 13193-] 

F. 1 blank; ff. 41-47 (sign, f) supplied in MSS; 
additional Jacetix on f. 55. 

Regius, [Raphael]. [Epistolae Plinii] [F.ia 
tit. (c.sign.a, :] Raphaelis Regii epistolae 
Plynii: qua Iibri naturalis histo | riae 
Tito Vespasiano dedicantur: enarrationes. 
I Eiusdem de q[ua]tuor Persii Iocis: uno 
Valerii maximi: duo- | bus TuIIii de offic- 
iis: ac tribus oratoriis q[ue]stio[n]ibus 
disputatio. Eiusdem de quibusdam 
Quintiliani Iocis cum quodam | Calfurnio 
dialogus. I Eiusdem loci cuiusdam Quin- 
tiliani ac eius Cicerouis [sic] ad | Atticum 
epistolae: cuius initium est: Epistolam 
hanc conuicio | efflagitarunt codicilli tui: 
enarratio. [F.ib:] RAPHAEL REGIVS 
DOMINICO GRIMANNO PA- 1 TRIC- 
IOVENETOEQVITI SPLENDIDISSI- 
MO SE I NATORIQVE SAPIENTISSI- 
MO SALVTEM. | [Scripta est ep.:] Pa- | 
duae pridiae [sic] nonas martias. Mccccl- 
xxxx. I [F.2a(c. sign. a2):] IN PLINII 
MAIORIS EPISTOLAM AD TITVM 

- VE I SPASINVM RAPHAELIS REGII 
ENARRATIONES. | [F.37a:] *** rogat 
Gulielmus Tridi- | nensis cognomento 
Anima mia: cuius opera hoc opusculum | 



Venetiis fuit descriptum Principe August- 
ino Barbadico de | cimo Calendas Iunias. 
Mcccclxxxx. I 

38 ff. 4 . Venetiis, Guillielmus (de Piano) 
Cereto de Tridino de Monteferato cogno- 
mento anima mia, 1490. 

[Hain no. 138 10.] 

Savonarola, [Giovanni] Michele. [De 
balneis et thermis naturalibus omnibus 
Italiae.] [F.ia:] Ad Illustrem d[omi]n[u]m 
Bo [r] siu[m] estensem Ca | strinoui tor- 
tonensis d[omi]n[u]m. Iibellus Micha | elis 
Sauanrole Illustris p[ri]ncipis d[omi]ni Ieo 
nelli marchio[n]is estensis ph[ys]ici.de 
balneis [et] termis naturalibus omnibus 
ytalie sicq[ue] to | tius o[r]bis p[ro] 
p[r]ietatibusq[ue] ea[rum] i[n]cipit feliciter 
I [F.39b:] Explicit liber de balneis [et] 
termis na | turalibus o[mn]ibus ytalie 
p[ro] p[r]ietatibusq[ue] earu[m].editus a 
d[omi]no Michaele Sauo | narola. im- 
p[r]essus Ferrarie p[er] m[a]g[ist]rum 
Andream gallum. M°.cccclxxxxv°. die x.° 
me[n]sis noue[m]b[r]is. Deo gr[ati]as — 
Finis. I Registru[m] huius Iibri. | 

39 ff. 4 . Ferrariae, Andreas Bellfortis Gallus, 
1485. 

[Hain no. 14493.] 

TORRELLA VALENTINUS, HlERONYMUS. 

[Opus praeclarum de imaginibus astrolo- 
gicis.] [F.ia.tit. :] Hieronymi [to[r]reIIame- 
dici Ua | Ientini opus p[r]eclaru[m] de ima- 
ginibus astrologicis no[n] | soIu[m] medicis 
verum e | tiam Iitteratis vi | ris utile ac 
ame | nissimu[m] | fF.92a.L22. :] Et [com]- 
pletu[m] e[st] hoc opusc[u]I[um] p[r]ima 
me[n]sis Dece[m]b[r]is anno salutis 
[christ]iane. Mcccclxxxxvi. Finis. | 
§ Impraessu[m] est hoc opusc[u]I[um] 
Uale[n]tie p[er] aIfonsu[m] [de] o[r]ta | [F. 
93.] § Correctio | 

[93] ff. 4 . Valentiae, Alphonsus de Orta, 1496. 
[Hain-Copinger 15560.] 

Only work issued by this press. Only one other 
copy in America. 



EDITORIALS 



ABRAHAM JACOBI (1830-1919) 



With the death of Dr. Abraham Jacobi, 
at Bolton Landing, N. Y., on July 10, 1919, 
at the age of 89, there passed away the 
founder of American pediatrics and one of 
the great leaders of our American profes- 
sion. In spite of injuries sustained in a fire 
at his summer home, in which some of his 
valuable manuscripts were lost, Dr. Jacobi 
retained his cheerful poise and serenity to 
the last. 

He was born on May 6, 1830, in the 
village of Hartum, Westphalia, where his 
parents conducted a small business in 
cattle-trading and storekeeping. His early 
education, acquired with difficulty at the 
village school and the Gymnasium at 
Minden, fitted him for matriculation at the 
University of Greifswald in 1847, an< I after 
the usual sequence of semesters at other 
universities (Gottingen and Bonn), he 
graduated at Bonn in 1851. His graduating 
thesis was a Latin dissertation "Cogitationes 
de vita rerum naturalium (Cologne, 1851), 
which is, in effect, a materialistic considera- 
tion of the nature of life and the forces of 
nature. Its conclusions are nil extra nat- 
uram; nil extra materiae leges, nullus in 
natura hiatus. 

While at Gottingen, Jacobi became in- 
volved in the revolution of 1848, his polit- 
ical activities were continued at Bonn, 
and when he went up to Berlin for his state 
examination, he was arrested on a charge of 



Iese majeste, and imprisoned for two years. 
Escaping to England in 1853, he finally 
reached America, and eventually settled 
down to practice in New York, where he 
was soon able to make a living. In 1854, he 
invented and used a laryngoscope, some 
time before the appearance of Garcia's in- 
strument. In 1857, he was lecturing on 
pediatrics in the College of Physicians and 
Surgeons of New York, being the first to 
teach this specialty in the United States. 
Later on, he was successively professor of 
diseases of children in the New York Medi- 
cal College (i860), the Bellevue Hospital 
Medical College (1861), the Medical De- 
partment of the University of New York 
(1865), and again in the College of Physi- 
cians and Surgeons (1870-99). He taught 
his specialty for nearly half a century, and 
in 1862, established our first pediatric clinic 
in the New York Medical College building 
in East 13th Street. He thus, as his col- 
league Adams has said, "pressed the button 
which set the pediatric clinic in motion," 
and, incidentally was the first to institute 
public bedside teaching in our country. 

During his long and active life, from the 
date of his inaugural thesis, Dr. Jacobi was 
a prolific contributor to medical literature. 
Mere writing became second nature to him, 
his mastery of the English idiom was com- 
plete, his knowledge of his science set off 
by wide and varied reading, particularly in 



194 



Editorials 



195 



the literature of classical antiquity and of 
the history of medicine. His writings fall 
readily into three classes; viz., the larger 
treaties and monographs, such as those on 
diphtheria (1876), intestinal diseases of 
infancy and childhood (1887), therapeutics 
of infancy and childhood (1896- 1903) and 
the splendid study of infant hygiene in the 
Gerhardt Handbuch (1876); the original 
scientific contributions, such as that on 
diseases of the thymus gland (1876), and 
the many descriptions of infantile disease 
in the American and German periodicals; 
and the brilliant array of miscellaneous 
essays addresses, public letters and speeches, 
which have been gathered in the "Collect- 
anea Jacobi" (8 vols. 1909). The latter in- 
clude some of the best things ever written 
on the history of pediatrics, in particular 
the history of American pediatrics in the 
eighteenth century (1902), the St. Louis 
address of 1904, the elaborate and authori- 
tative history of American pediatrics 
in the Baginsky Festschrift (1913), the 
history of cerebro-spinal meningitis in 
America (1905) and the history of pediatrics 
in New York City (1917). To the general 
history of medicine, he made many learned 
contributions, notably the compact histories 
of nursing (1883) of American medicine 
(1900), of therapeutics (1905), of medical 
libraries (1906), the wonderfully exhaustive 
and patriotic letters to a German periodical 
on the condition of American medicine in 
1909, and the charming biographical 
sketches of Samuel Bard, Virchow, Austin 
Flint, Carl Gerhardt, Ernst Krackowizer 
and others. Mention should here be made 
of the monumental discourse "Non Nocere," 
delivered at the International Medical Con- 
gress at Rome in 1894, replete with practical 
sense, and the learning and wisdom of a 
lifetime. The writings of Jacobi are remark- 
able for racy idiomatic English (which he 
wrote like a native), intellectual and civic 
courage of the highest order, omnipresent 
humor and a delightful vein of quaint, 



elusive irony. In addressing an audience, he 
never flattered them, but, in his pleasant, 
humorous manner, told them plain, un- 
varnished truths. Concerning this trait, Dr. 
Robinson, the editor of the "Collectanea 
Jacobi," has said: 

"What attracted me to Dr. Jacobi long 
before I had the pleasure of his personal 
acquaintance was his sturdy honesty, his 
rugged fearlessness, which one could readily 
feel in his public speeches and addresses. 
He never missed an occasion to inculcate a 
wholesome lesson. And he was never afraid 
of his audience. Where another person 
would pour out fulsome, cloying praise, 
he would offer healthy criticism; where 
another person would dispense nothing but 
taffy, Dr. Jacobi would present a good dose 
of Epsom salt; to dispense undeserved 
flattery has always been as distasteful to 
him as to receive it. And if his audience did 
not like some of the wholesome but bitter 
truths that he gave them, why, he just let 
them dislike them." 

In 1865, John Stuart Mill, prior to his 
election as member for Westminster, was 
publicly asked whether he had written a 
passage stating that the English working 
classes were "generally liars," and elicited 
tumultuous applause by replying simply "I 
did." Under other conditions of space and 
time, he might have been greeted with a 
volley of oaths or brickbats. In public and 
civic relations, Jacobi was ever one of 
Milton's "sad friends of truth," the man 
who cares more for the truth than for him- 
self or his own personal safety. His utter- 
ances under this head are to the point, the 
views of one who constantly kept the finer 
morale of life in its proper place, at the 
front: 

"When your anger arises within you over 
some unjust thing, be not afraid of showing 
the blush on your face; when an iniquity 
is perpetrated, resent it. Be not afraid of 
slapping the cheek that deserves it in private 
or in public. Personally I hate enmities; 



196 



Annals oj Medical History 



they always fretted and worried me and 
gave me sleepless nights; but I never was 
afraid of the enemies I made as long as I 
fought the battle of professional or civic 
decency and dignity. If there be a bad, or 
a ludicrous, or a dangerous man, and if he 
feels offended by my telling him of his 
misdeeds and my trying to protect the pro- 
fession or the community against him, here 
I plead guilty, and I shall do it again for- 
evermore. When I shall stop, then call me 
old." [1900.] 

"Many a young man sins because he 
knows no better, and was not told. If the 
teachers of medicine, if the great professors 
of specialties in the schools of learning, 
neglect the duty of teaching from their 
platforms the morals as well as the science 
and art of medicine, it is they from whom 
comes the harm." [1894.] 

Who, save Emerson or Thoreau, has 
spoken so plainly and forcefully of our 
national failing, smooth humbuggery? 

"And here is a word to the young. I am 
afraid we old men are past changing, but 
it is a failing in our national character to 
be always cordial, always courteous, always 
handshaking. We do not identify the sin 
and the sinner; we abhor the former, and are 
too good-natured to shun the latter. If 
there be a danger to our morals and our 
politics, it is there. If you, the young men 
in the profession, will refuse approval and 
honors to men whose actions and methods 
you condemn, if you will only show them 
that your heart is chilled against them — 
some of them are in public positions — there 
will soon be an end to offences which need 
not always result from wickedness, but 
from bad taste only. There are those indeed 
among the vain who fear the display of bad 
taste more than the perpetration of sin." 
[1900.] 

Equally vigorous and straightforward are 
Jacobi's strictures on the land of his birth, 
as he knew it in his youth. One recalls the 
remark of Helmholtz that the English 



universities excelled in turning out men who 
wrote their language well and whose tradi- 
tions and training were those of the gentle- 
man; or Billroth's condition that his favored 
assistants should be men of gentle nurture 
(aus gutem Haus sein), as contrasted with 
those who have "the information but no 
corresponding degree of refinement." 

"How low would be the level of our 
German Fatherland were we to judge it 
only by its visible leaders ! For these do not 
grow simultaneously with a new generation 
or with a new century. At the beginning of 
the century, Stein; Fichte, the philosopher 
of the German nation; at the end, the vain 
and deluded Nietzsche. One hundred years 
ago, Schiller and Goethe, Wallenstein and 
Faust; to-day, Sudermann and his 'Sturm- 
geselle.' " [1903.] 

"The latest events at the German uni- 
versities are not calculated to confirm one 
in the impression that the study of the 
humanities necessarily has for its product 
humane youth. The brutalities of the anti- 
semetic movement find their chief leaders on 
the one hand in the refuse of the ignorant 
populace of the large German cities and on 
the other in the 'jeunesse doree' of the 
gymnasia. The mediaeval barbarity of the 
'hep hep' delirium is diligently practised 
by the young men who, as has been docu- 
mentarily proven, have had the advantage 
of an acquaintance with Homer, Horace, 
and even Sophocles. Judging from the 
German press there is not a more repulsive 
class of brutes than that which loves to 
give itself such airs in the German audi- 
toria and beer-houses. Unfortunately these 
are facts well-known to all of you. Although 
in the light of our more liberal institutions 
and our more humane manner of viewing 
things, they surpass our understanding. 
This much, however, is certain that either 
Homer, Horace, and Sophocles alone will 
not redeem the barbarian, or that forsooth 
the study of the great minds of the ancient 
world as it has been and still is carried out 



Editorials 



197 



in the German secondary schools is capable 
perhaps of stuffing the head but not of 
purifying the heart." [1880.] 

"So long as the honor of the student 
permits or demands that he jostle the 
civilian and call him philistine, so long as a 
great number of the songs he sings in his 
Kneipe are drinking songs or worse, so 
long will he be devoid of any sense of inti- 
mate coherence with and respect for his 
own family, the citizen, the people. The 
dashing students of my period, therefore, 
became the best servants of the State, 
according to Bismarck's views. Whatever 
liberty they wanted they had had in over- 
flowing measure at the university. The 
prosecutors in the Communist trials at 
Cologne, and in the much more horrible 
Rostock trials, were all former dashing 
students. When I witnessed a performance 
of Alt-Heidelberg, tears of rage rose in 
my old eyes. In this play the loud, noisy, 
thoughtless gayety of the students is 
promptly transformed into toadying and 
servile shrinking the moment their fellow- 
student — against his wish and merit — 
becomes a reigning prince. How much better 
does the prince appear than his former 
boon companions, now all submissive 
devotion!" [1903.] 

"In F. Nasse, I had, fifty years ago, a 
teacher of unadulterated humanity, com- 
bined with all the scientific eagerness of 
his mental youth of exactly seventy years. 
From him also, though he was not a 
democrat nor a revolutionist, I learned the 
sacredness of individual right and life which 
I have never ceased to respect. Thus I 
learned two things: first, never to let up 
in my care of individual life when entrusted 
to me; secondly, that no single political or 
religious creed ever owns, or controls, or 
interferes with the dictates of humanity 
and common sense. Man is above theories 
or creeds." [1900.] 

But if Jacobi indulged the "whom he 
Ioveth he chasteneth" principle in criticizing 



American conditions, he would permit no 
one else to criticize them. I have known 
him to take up the cudgels for the slightest 
medical journal, the smallest medical 
society. His interest in American medicine 
was sincere, and his feeling for his adoptive 
country was one of genuine gratitude. 

"Books on general American topics, like 
that of the surly and clumsy L. Buechner 
of Germany, or that of the ignorant and 
stupid though elegant Bourget, of France, 
written after a few weeks' hasty observa- 
tions with narrow opportunities, are more 
apt to obscure the mental view than en- 
lighten the mind. The spirit of de Tocque- 
ville is no longer alive in the tourist. " [1900.] 

"Yes, we poor Americans have at last 
reached the point when, during sessions of 
International Congresses, entire papers — 
left with the publishers before the author's 
departure — 'telegraphed over on account 
of the great interest which they aroused' 
are published by the daily papers. All this 
happens, I admit, but it is not American 
but only commercial, speculative. We suffer 
grievously through transactions of this 
sort, and through the presence of this sort 
of men in the great medical forum. The 
process of learning that which modestly 
remains in the background, is a slow one; 
only that which loudly pushes to the front 
easily makes a general impression." [1900.] 

"I came here a foreigner, and never was 
made to feel I ever was a foreigner. I 
emerged from a European state prison to 
breathe the pure air of a free country. My 
political and social ideals were not all 
fulfilled, it is true, for nothing is perfect 
that is human; that is why it was still 
necessary for me to be an abolitionist and 
a mugwump, with the perfect assurance — 
which I still hold — that some time or other 
the minority turns out to be the majority." 
[1900.] 

"Who is there that wondered that when 
many years ago the great honor of a 
responsible position in a foreign country 



198 



Annals oj Medical History 



was offered me, it took me a single minute 
only to decline? I was, I am, rooted in the 
American profession, that I have observed 
to evolve without governmental aid, out 
of its own might, to become equal to any 
on the globe. I was, I am, rooted in the 
country that was my ideal when I was 
young, my refuge when, alone and per- 
secuted, I stole away, and always, clouds or 
no clouds, my sunny hope forevermore. " 
[1900.] 

Contrast these exalted utterances of 
refined patriotism, with his captivating 
banter at one of the Ann Arbor dinners. 

"In the circular of your committee of 
arrangements, reference is made to the 
Ann Arbor round table, an unassuming 
way they have of speaking of themselves. 
My intuition tells me it was more. That 
secret round table was a sort of modern 
Grail Society, which assembled, like the 
Knights of the Ancient Grail, under the 
tavern sign of the dove. They met annually. 
From Wagner's "Lohengrin," you recollect: 

'Once every year a dove from heaven descended, 
To strengthen the Grail anew for works of grace.' 

"The dove, however, was not exactly a 
dove, but some other biped, such as a squab 
or chicken, or duck, with concomitant 
vegetables and what is called in English 
'hors d'ceuvres, entrees, sauce a. I'Anglaise,' 
etc. There is this difference, however, 
between the mythical grail and the modern 
round table, that our men did not insist 
upon being unrecognized. What they want 
of you they say over their own honored 
names, — and when I look about I know 
they have succeeded." [1899.] 

Arch and piquant, also, were his passing 
references to the history of medicine. His 
knowledge of the subject was wide and 
deep, but there was no pedantic parade of 
learning; the theme was usually exploited 
by him as a vehicle for wit, much as the 
modern French painters employ color solely 
to convey the sensation of light and motion. 



"Rokitansky and Skoda cared more 
for the dead bodies than the living con- 
valescents; the former proclaimed loudly 
that the only thing scientific in medicine 
was the autopsy, and the Nihilism of Vienna 
was that time's modern therapy. You and 
the patient met only twice — first, when 
you made the diagnosis of his case; second, 
at his autopsy." [1900.] 

"Old Cato, the arch enemy of Carthage 
and of the Greek physicians who im- 
migrated into Rome, cured everything with 
cabbage and incantations. Antonius Musa, 
who lived one and one-naif centuries later, 
was the first exclusive hydropath of the old 
style that used cold water only. He cured 
the Emperor Augustus and enjoyed riches 
and honors. The Emperor's nephew, Mar- 
cellus, however, died under the treatment, 
and Dio Cassius charges the doctor with 
having killed his patient — tout comme chez 
nous." [1904.] 

"We are not so fortunate, as, according 
to Herodotus, the ancient Egyptian doctors, 
'who had many advantages,' he says; 
'who spent and consumed none of their 
own property, but ate the ritual offerings, 
and received every day many geese, and 
meats, and wine.'" [1898.] 

"As Virchow expresses it, every epidemic 
is a warning that should teach a statesman 
that there is a preventable or curable dis- 
order in the organism of the commonwealth. 
Unfortunately it is too often true, what 
Anarcharsis said of Athens, that the wise 
men do the talking and the others the ruling. " 
[1900.] 

"Hahnemann was learned, so he found 
it easy enough to adopt the principle of 
potentialities from Arnold of Villanova, 
who lived 400 years before, and that of 
similia similibus from Paracelsus." [1904.] 

"When the great surgeon, Dupuytren, 
had an empyema, he was told to have it 
opened, and he replied that he preferred to 
fall into the hands of God rather than 
that of man. So he did fall into the hands of 



Editorials 



199 



God in the year 1835, only 57 years old. 
Mind, that was in the nineteenth century, 
when the hands of Laennec's successors, 
Andral, Piorry, Louis, could have been had 
for the asking." [1905.] . 

"Not very long before my time the 
amenities of professional intercourse cannot 
have been very great, when Lisfranc called 
Dupuytren the butcher of the Hotel Dieu, 
and Dupuytren dubbed Lisfranc the mur- 
derer of the Charite." [1900.] 

"A mechanic is expected to learn his 
handicraft before practising; but the medical 
student is permitted to practise on his 
fellow men without having the required 
schooling. This is what gives so much prob- 
ability to Ughetti's story of a Scotch king 
who would not admit a doctor to his own 
land until he had practised at least twenty 
years amongst his enemies." [1905.] 

"There is nobody, however, who can 
know all the various specialities or practice 
them. Seneca said 2,000 years ago: 'The 
man who is everywhere is nowhere' — 
nusquam est qui ubique est." [1904.] 

"Nearly forty years ago my surgical 
colleague, Carnochan, performed operations 
in the then New York Medical College on 
the cadaver and on the living patient on 
the same revolving table in the amphi- 
theater, in the same purple velvet gown, 
and, I do not remember, perhaps even 
with the same knife." [1899.] 

But, it is after all, in the field of his 
actual life-work, the practice of medicine 
and the ethics of the profession, that we 
find Jacobi at his best. Here he is at once 
learned, pungent, practical, informed with 
wisdom, rectitude and the genius of 
humanity. 

" In large cities the thorough, all-around, 
general practitioner is becoming scarce. 
Now and then he is expected to be but the 
city directory, or the agent for the specialists 
in brain and nerves, in kidneys and appur- 
tenances, in uterus and appendages, in skin 
and corns, in heart and lungs, in stomach, 



throat, nose, eyes, ears, and what not. It 
will be very difficult to stem the current, 
for, indeed, the evolution of specialties, 
both in science and practice, is spontaneous 
and legitimate. But the waters left their 
bed long ago. The tendency of the time is 
mercenary, the medical man is still a man 
and but human and many a one is very, 
very young, and expects to make a great 
reputation and an easy living out of very 
little mental capital, and out of a little 
manual dexterity, to the neglect of general 
medicine." [1894.] 

"A young medical man who runs off 
into a specialty, honestly believing that a 
human organ can be studied and treated 
separately, like the wheel of a watch, 
has not intellect enough to be a physician, 
and ought to have been discouraged from 
entering the ranks. He who undertakes it 
from mercenary motives ought to be frowned 
down, and told that his tendencies and 
faculties belong to the places where they 
sell their wares and souls for lucre, and call 
it business, not a sacred vocation." [1894.] 

"Statistics are said to prove that pneu- 
monias will get well without medication. 
Which pneumonia, and whose? It should be 
a great satisfaction to a man dying of 
pneumonia to learn that his neighbor got 
well without medication, if stimulation in 
time, perhaps venesection, might have 
saved his own individual life. It is the 
duty of the physician to judge of and to 
treat his individual case, and not the 
pneumonia of Louis and of Dietl, and of 
other statisticians. Treat the man who is 
sick, and not a Greek name." [1898.] 

"I was present when a minister of the 
gospel in my city rebuked us doctors 
roundly for not finishing the misery by a 
friendly poison. When I heard it, I remem- 
bered the little sentence in the Latin primer 
of my early childhood:' Medx projiciebant 
moribundos canibus; 'the Medes threw the 
dying to the dogs.' When we doctors become 
Medes, we shall obey the ruling of that 



200 



Annals oj Medical History 



clergyman. Meanwhile we have sworn with 
Hippocrates : ' I will give no deadly medicine 
to anyone if asked, or suggest any such 
counsel.'" [1905.] 

" I am so convinced of the good effect of 
a spare diet in old people, that I have often 
insisted that the change be made. In con- 
sequence, I have frequently seen aged men 
and women with sour temperaments, flat- 
ulency and muscular and mental incom- 
petency, become cheery and active — nor 
old people only. According to Keith's East 
Indian experience, it is the unanimous 
verdict that spare frames and spare eaters 
bear tropical climates best. Three hundred 
pounders do not prove satisfactory. The 
teacher who initiated me into the mysteries 
of the alphabet was very frail and was 
considered tuberculous. Being so lucky as 
to have to live on the equivalent of $30 a 
year, and not striking oil at any time, he 
lived on healthy but spare diet up to his 
present age of 87, which he spends with 
books and painting. Thus it happens that 
the feeble should not be despaired of; 
they may reach an old age, while the very 
vigorous, who do not suffer at once from 
their transgressions, are tempted by this 
apparent immunity to repeat them and 
succumb to their consequences. Nor do I 
think that the old Egyptians would, al- 
together, protect themselves against the 
results of their indiscretions by their custom 
of taking a purgative and an emetic three 
times a month." [1898.] 

"When the Vienna school, following the 
French under Broussais and others, elabo- 
rated pathological anatomy and diagnosis — 
I refer mainly to Rokitansky and Skoda — 
they declared that diagnosis and autopsy 
were the only quintessences of medicine. 
Even Wunderlich proclaimed in his early 
career that medicine should be science, not 
art. But the very accuracy of the diagnosis 
and of autopsies facilitated the appreciation 
of the effects or of the failures of medicines. 
The co-operator of those illustrious men — 



Hebra — proved every day of his life that 
diseases, hitherto incurable, were cured 
and healed by local treatment. The isolation 
of morphine by Magendie, and of numerous 
alkaloids afterward, rendered medication 
more accurate and controllable. Annual 
experiments added wonderfully to the cer- 
tainty of drug-action; it was soon learned 
that much of that certainty was due to the 
chemistry of the drugs; this was the first 
step in the direction of compounding new 
drugs by snythesis." [1898.] 

"Do not blame bacteriology for the sins 
of some few workers." [1905.] 

"There has been, for instance, an egregious 
amount of talk among us about the power 
of nature and the incompetency of man. 
Natura sanat, medicus curat. Nature is 
the healer; the medical man just takes care 
of the patient, and sees to it that nature can 
perform its work. Why, then, insist upon 
these cruel and brutal exertions, most of 
which are discovered and advised by men 
possessed of a schematic knowledge of a 
pathological process, which leads them to 
kill their patients while trying to destroy a 
bacillus? Le sujet est mort, mais il est mort 
gueri." [1894.] 

"Nature does not kill and does not heal. 
If there were consciousness in nature, she 
would feel indifferent about what she is, 
viz., mere evolution. Nature is sunshine 
that grows harvests and sunstrokes; she 
makes moonshine for lovers and for bur- 
glars, and rain to feed men and to drown 
them, and the sun warms the unjust and 
the just. Nature is a Mauser bullet; stand 
in its way, you are hit; dodge, and you are 
saved — it makes no difference to nature. 
In nature a diphtheria bacillus has its 
democratic rights and duties like George 
Washington, and it killed him; she has not 
predilections, no reasoning; she is cause 
and effect. She can be led and doctored. 
The engineer heals her deformities in the 
interest of commerce; insurance companies 
correct her failures or calamities; indeed 



Editorials 



201 



the logical mind of man and the logical 
necessities of "nature" are engaged in a 
constant strife for superiority. In matters 
of health and disease of homo sapiens the 
doctor utilizes or combats the doings of 
nature. By caring he cures. Curing has long 
ago lost its literal meaning (curare). 
It is healing." [1898]. 

"The old physicians, with their maxim 
qui bene purgat, bene curat, hit the nail 
quite frequently." [1898.] 

"If the countries be overrun with pro- 
prietary and quack medicines and foods, 
it is to a great extent the fault of the 
doctors, even those highest in rank. They 
will accept and praise and certify to the 
merchandises of the vendors — I am afraid 
some of you carry them in your own 
pockets this moment — open and strengthen 
the market for them, and thus educate 
their public into attending and drugging 
themselves. If there is to be a pharmaceuti- 
cal gospel, it ought to be for all of us the 
national pharmacopoeias." [1894.] 

"Medicine, like politics, will be purer 
for the money put into it, instead of being 
taken out of it." [1900.] 

"We all agree not only that over-dosing 
is wrong and harmful, but also that it is 
being practised. To give mercury to saliva- 
tion; salines until the rest of soluble albumin 
and salts is gone; digitalis until heart and 
pulse are below danger line; belladonna 
until the throat is as hard as a gridiron; 
quinine until you get deaf; iron until gastric 
catarrh and constipation destroy what is 
left of health; to burn noses for everything 
in the line of ailment that may befall the 
flesh; to cut the cervix uteri for sterility 
and endometritis; to sew up the cervix 
uteri for sterility and endometritis; to 
cauterize and otherwise handle the prob- 
lematic ulcerations of the uterus for sterility 
and endometritis, are abominations to the 
minds of well-meaning physicians. Still 
they are being done, and will continue 
to be done until knowledge increases, 



judgment improves, the mercenary spirit 
disappears from our ranks, and perhaps the 
public refuses to submit. Non noceatis" 
[1894.] < 

"It is not enough to avoid legal re- 
sponsibility, the civil law is mostly on 
your side — our law-book is the history of 
our art and the dictates of our heart. Both 
say that the so-called expectant treatment 
has done, and is daily doing, more harm 
than over-dosing. Our sins are those of 
omission as well as of commission. A 
whooping-cough leading to broncho-pneu- 
monia, pulmonary hemorrhage, or con- 
vulsion in the fifth or sixth week, while it 
might have been mitigated or checked 
before, is an arraignment of the doctor. 
The self-limited eruptive fevers, measles, 
scarlatina, typhoid, each of them liable to 
lead to myocardial changes, heart failure, 
and death, or to mental disturbance, which 
were not actively treated in time by 
absolute rest, reduction of heat, and 
moderate or vigorous early stimulation; 
the pneumonia which, when delirium, 
cyanosis, and dilatation of the right heart 
became urgent dangers, was not relieved 
by a venesection; the protracted and 
hesitating convalescence, with its anaemia 
and flagging pulse, which was not supported 
by heart tonics, not 'pro re nata,' for res 
was 'nata' already, before it was too late 
forever, are, and must be for life, loads 
on the practitioner's conscience. Sophocles 

says (Aias 581) : 'ov irpos larpov aoOov &pr)vtlv hiroSas 

npbs topmvti. Tnj/tcm' (No bright physician 
mourns plaintively over a case where he 
ought at once to use the knife)." [1894]. 

"You do not save a burning building 
with an atomizer, but with a hose." [1905.] 

"In accordance with my democratic 
schooling, I was fortunate enough to have 
respect for the individual. That is why I 
found it easy to imagine myself in the 
place of a patient, and to spare his feelings 
if I could not preserve his life. Where 
you cannot save, you can still comfort. I 



202 



Annals oj Medical History 



never told a patient he had to die of his 
illness, and hope I shall never be so careless 
or so indolent as to do so in future. The 
magnetic needle of professional rectitude 
should, in spite of occasional deviations, 
always point in the direction of pity and 
humanity. Another lesson I learned early 
was this, that my patient had to be treated, 
and not the name of his disease, and, also, 
as my illustrious medico-poetical friend 
proclaimed in Washington a few days ago: 
' 'Tis not the body, but the man is sick.' " 
[1900.] 

"Listen to what I read in Ughetti's book 
— I believe he spoke of you and me: 'When 
a doctor runs away from an epidemic he 
is a coward; when he stays and fights it, 
he is forgotten; when it kills him, his 
family will starve.' I have seen all that and 
it looks gloomy, does it not? But you do 
not look frightened at all. And such is the 
fascinating sacredness of the calling you 
are entering upon, my young colleagues 
and fellow students, and if you asked 
an old man who had been through hard 
lifelong work and heart-rending scenes, 
through successes, maybe, and endless 
failures and disappointments, if you asked 
him what he craved to be if he began life 
again, he would, I think, reply: 'Just a 
modern doctor.'" [1905.] 

From the remaining extracts subjoined, 
one may further sense the depth of 
Jacobi's wisdom, the edge of his wit, and 
the wide range of his interests and ex- 
perience. 

AUTOBIOGRAPHICAL 

"The first of my professional successes 
was the fact that it took my first patient 
only a fortnight after my new shingle began 
to ornament No. 20 Howard Street, to 
call on me with his twenty-five cent fee. 
That was in November, 1853. I must have 
had quite a reputation at that time, for 
his only excuse for coming at all was that 
he had heard of me. I think I must have 



gathered many more such fees, for after 
less than four years I was one of the founders 
of the German dispensary, in which treat- 
ment was strictly gratuitous. About the 
same time of this memorable achievement 
of mine, Dr. Stephen Smith, that good 
and glorious man, accepted from me a long 
series of extracts from European journals 
and books, mostly on diseases of children, 
and within another year, he was pleased 
to accept, what I am still pleased to call, 
original articles. About the same time my 
inexperience made me try my first lecture 
on half a dozen suffering students (in the 
spring course, of 1857) of the College of 
Physicians and Surgeons. I nearly broke 
down, more or less deservedly. My subjects 
were the diseases of the young larynx and 
laryngismus stridulus. Nolens volens I ex- 
hibited in my own person an attack of 
laryngismus. We all survived. A similar 
experience I had three years afterward 
when I had been made professor of infantile 
pathology and therapeutics in the New 
York Medical College, then located on East 
13th Street. If some one were anxious to 
learn how I, with my knowledge of pathol- 
ogy and therapeutics, which indeed was 
rather infantile, became a professor, this is 
how it happened. A friend of mine, who has 
a tablet of his own in the history of American 
obstetrics, had taken a chair in the re- 
organized school. So my dear Charles Budd 
wished me to go in with him, and came as a 
committee to offer me a place in the 
faculty. When I used what I had of common 
sense and replied that I did not feel com- 
petent, he tried his great art on himself. 
He delivered himself, with forcible tongue, 
of so many uncomplimentary remarks about 
me, that I accepted his terms at once. 

"The very next year, the eighth, I made 
a heap of money out of literature, which is 
remarkable for a medical man, unless he be 
Weir Mitchell, or Osier, or Holt. It happened 
this way, — perhaps someone wishes to 
imitate me. Indeed, I believe he should. 



Editorials 



203 



In 1859, E. Noeggerath and I published 
a big volume, 'Contributions to the 
Diseases of Women and Children,' at an 
expense to ourselves of $800; a few years 
afterward we sold the edition as waste 
paper for sixty-eight dollars, a clear profit — 
compared with nothing. 

"Thirteen years passed, and I suffered 
from fire; some rare books and specimens 
that I could never replace burned down 
with the University Medical College build- 
ing on Fourteenth Street. Over the ashes 
of my property Tammany Hall was erected, 
which refuses to burn, at least in this world. 
About the same time I cashed my first big 
hospital check in the shape of a petechial 
typhus, of which I got well after public 
prayers had been offered by some good old 
ladies. 

"After seventeen years, I scored quite a 
success when I — refusing to resign — got 
myself expelled from a public institution 
for proving a hundred per cent mortality 
amongst our babies, and for insisting upon 
a farming-out system." [1900]. 

"When I was a young student, the 
medicine of Germany was just waking up 
from a forty years' slumber caused by the 
unintelligence of what was called nature 
philosophy. At that time, the Viennese 
learned pathological anatomy from the 
French. One of the greatest teachers of 
that branch was Rokitansky. For him all 
there was in medicine was the study of 
the dead body. For Skoda, however, all 
there was in medicine was diagnosis, mostly 
through percussion and auscultation. For 
the patient, all there was to do was to go to 
the hospital, to be diagnosticated by Skoda, 
and to be opened by Rokitansky. Medical 
science and the patient met only twice, 
once on the hard hospital bed, next on the 
autopsy table. The patient had done his 
full duty when the diagnosis and the result 
of the post mortem examination agreed. 
Of therapeutics there was none. The time of 
big medicine bottles with the nauseating 



draughts had gone by, thanks to Hahne- 
mann, however, could not meet with the 
approval of unsophisticated savants. So 
there were no drugs, no treatment. While 
formerly both medication and bloodletting 
had been overdone, now everything was 
discarded. Dietl, of Vienna, and Ham- 
mernjk, of Prague, founded that nihilism 
of the Vienna school that under the flag 
of so-called pure science had resulted in 
driving the patients into the camps of 
sectarians or quacks, who after all hold out 
some promise to the despairing." [1905.] 

NEW YORK IN 1 788 

"Nearly a hundred years ago, when the 
first dispensaries were established, religious 
feeling was no longer strong enough to 
prompt the giving of proper care to the sick 
and helpless. The only public hospital in 
New York was the New York Hospital. 
And this was held in such slight esteem or 
respect for its public service that in April, 
1788, the sight of a human limb at one of 
the windows caused a bloody riot, the 
'doctor's mob,' in which a number of 
prominent citizens, among them John Jay 
and Baron Steuben, were wounded by the 
ruffians. The physical and moral condition 
of the masses — even in a city that hundreds 
of years ago counted but 23,000 inhabitants 
— was so depraved, that only those can 
perhaps form an idea of it who are able to 
recall the July riots of the year 1863. And 
those who have read the painfully exact 
description by McMaster of certain social 
conditions, cannot refuse their admiration 
to those physicians and laymen who estab- 
lished the first dispensaries in aid of the 
indigent sick. " [1900.] 

RECOLLECTIONS OF JOHN W. FRANCIS 

"His literary and artistic tastes kept 
him in contact with professional men of 
all kinds. That is why very few men whom 



204 



Annals oj Medical History 



I knew in the profession of New York 
could at any time compare with him in 
mental breadth and vigor. He was very 
social when you knew him more intimately, 
and inclined to be jocose. I had seen him a 
few times only, when one day he stopped 
me at the corner of Broadway and Bond 
street, near where he lived. 'They speak 
well of you,' he said, 'and you will get on; 
only people want sometimes some outward 
show. Now, I am an old man, and you 
will not mind it when I say you ought to 
have another tailor.' I replied: 'You see, 
Dr. Francis, you are an old doctor, and 
famous, and you can afford to wear the 
old-fashioned clothing of the eighteenth of 
Brumaire and of the century of William 
Penn, but I cannot afford yet a better 
tailor.' My remarks on his clothing appeared 
rather to please than to shock him. He was 
somewhat inclined to be a little pompous, 
and the cut of his clothing was fashionable 
when he was a boy." [1907.] 

OVERPLUS OF MEDICAL SCHOOLS 

"In regard to our medical schools, it 
should be remembered that, with few 
exceptions, all of them were at one time, 
and most of them are still, private institu- 
tions. An intelligent American audience 
need not be told that vanity, avarice, 
territorial pride, professional jealousy, had 
a good deal to do with the mushroom 
growths. St. Louis and Chicago had at one 
time, and have perhaps to-day, thirty 
medical schools between them. That is why 
professors are as numerous as crab-apples 
and plain doctors are scarce, at least in 
large cities. I am certain I express the 
opinion of all here when I say that medical 
teaching will be better, and more uniform, 
and more in accordance with the require- 
ments of the public, when our one hundred 
and fifty schools will have been reduced to 
twenty-five, and each of them will be 
connected with a university as its medical 
department." [1900.] 



MAN S DEBT TO THE PAST 

"No single man can stand alone, a law 
to himself and others. Even genius is the 
child of its time. No Washington or Lincoln, 
no Hippocrates or Aristotle, no Virchow or 
Pasteur, or even Koch, none of these im- 
mortal ones is a world by himself, and an 
isolated, self-lit sun illuminating and warm- 
ing the universe. Every one has been raised 
on the shoulders of his predecessors. " [1880.] 

AUTHOR AND PUBLISHER 

"Our book stores are the largest and most 
magnificent in the world; public libraries 
are found in towns one side of which still 
adjoins the primeval forests or the prairie, 
and our publishers build themselves palaces 
— which, however, cannot be often said of 
the authors." 

A TEST OF SCIENTIFIC BOOKS 

"In forming a judgment of books, I use a 
method peculiar to myself. Should a novel, 
for instance, fall into my hands, I always 
look at the last page first. If they are 
married and live happy ever after, or if no 
other calamity occurs, the novel is readable. 
At least it does not help to increase earthly 
misery. But I must know beforehand that 
everything takes its proper course. And 
this is the way I frequently handle scientific 
works." [1901.] 

STATUS OF PEDIATRICS IN 1 898 

"Few professorships exist for pediatrics; 
and they are mostly nominal. The neglect 
shown it by the official faculties is readily 
taken by students as their guidance, and 
the results are unavoidable. Infants cannot 
complain, and they cannot vote; even less 
so than the private in an army. The old 
principle, 'injans nondum homo,' an infant 
is not quite a human being, has not died 
out yet. That the embryo and the fetus are 
of still less account is only too true. Genuine 
humanitarianism has not yet risen to the 
dignified place held even by the unborn 



Editorials 



205 



in the teaching of at least two religions — 
the Jewish and the Roman Catholic. After 
all, I hold that teaching pedology as an 
obligatory study, mainly at the bedside in 
children's hospitals, and raising it to the 
dignity of full chairs in our leading institu- 
tions, is amongst the most valuable means 
of reducing infant mortality." [1898.] 

STATISTICAL REPORTS 

"Nothing appears to be more eloquent 
than the figures of these glittering reports. 
Those, however, who remember the cham- 
pion liar Talleyrand's brilliant saying, are 
aware that language, printed and spoken, 
may conceal as much as it publishes." 
[1898.] 

ADVANTAGES OF TRAVEL 

"The Siamese twins were carried over 
fifty thousand miles, but I am sure the 
only place they knew anything about was 
their South Carolina village." [1905.] 

SAVOIR FAIRE 

"The wise Swiss Sonderegger — -to whom 
his countrymen ought to erect a monument 
before they forget what they lost by his 
death — says, 'The man who makes his own 
position awkward is always a fool.'" [1899.] 

"I have been told that though a man 
displays both thunder and lightning, he is 
not necessarily a Jupiter." [1909.] 

Dr. Jacobi was highly honored in his life. 
He was President of the American Medical 
Association in 191 1, of the New York 
Academy of Medicine and of many other 
societies. He received the degree of LL.D. 
from Columbia, Yale, Harvard, Washington 
and Jefferson universities, and from the 
University of Michigan. The complimentary 
dinner given to him in New York on his 
seventieth birthday (1900), with the pres- 
entation of a Festschrift, will be long 
remembered. On his eightieth birthday, he 
received a bronze medallion of himself 
from the Medical Society of the State of 



New York. He was an active publicist in 
the city, and had he lived to complete his 
ninetieth year, the demonstrations of grat- 
itude and praise would have extended far 
beyond the bounds of the local profession. 
The funeral ceremonies at the New York 
Academy of Medicine were impressive. 

In 1873, Dr. Jacobi married Miss Mary 
C. Putnam, a daughter of Mr. George P. 
Putnam, the publisher. She was the first 
woman admitted to the Ecole de Medecine, 
Paris, graduating in 1870; became a famous 
physician, and died June 10, 1906. Three 
children were born to Dr. and Mrs. Jacobi. 
The first died in infancy, and the second, 
Dr. Jacobi's much beloved son, at the age 
of seven, in 1883. Mrs. George McAneny, 
survives. 

Dr. Jacobi was a man of noble presence. 
His splendid head was of rare distinction, 
and acquired a leonine appearance en profil, 
as the wavy crown of hair whitened with 
age. The gaze of the fine eyes, now grave, 
now subtle, now humorous, was fascinating 
and compelling — 

"Desyeux attirants comme ceux d'un portrait." 
His manner, quiet, dignified, old-fashioned, 
like the subdued tones of his well-bred voice, 
was of unfailing charm. So great was the 
reverence in which he came to be held, 
that even in extreme old age, when he 
seemed like the wraith of some great master 
of learning of the past, his voice, however 
low and soft, could still be heard through 
the hush which fell upon public assemblies. 
In private life his conversation was some- 
times all banter, but no one could remain 
in his presence long without sensing the 
worth and value of an elevating personality. 
In such relations, he conferred an incalcul- 
able benefit by simply being himself. His 
future position in medical history is secure 
and high, and in the minds and hearts 
of those younger people to whom his kindly 
encouragement meant everything, his 
memory will have a shrine of its own, 
pia anima in pace. F. H. Garrison. 



2o6 Annals oj Medical History 

MEMORIAL NOTICE: MORTIMER FRANK (1874-1919) 



In the death of Dr. Mortimer Frank, at 
Chicago on April 21, 1919, at the early age 
of 44, the cause of medical history in this 
country loses one of its most promising and 
active adherents. Dr. Frank was born in 
Buffalo, N. Y., on May 26, 1874, and after 
the usual schooling in Chicago, graduated in 
engineering with the degree of B. S. at the 
Massachusetts Institute of Technology 
(1897). During the next two years, he was 
engaged as a civil engineer on the Cleveland, 
Cincinnati, Chicago and St. Louis Railroad. 
Subsequently taking up the study of medi- 
cine, he received his degree from the Medical 
Department of the University of Illinois in 
1 90 1. After taking post-graduate courses in 
Philadelphia and New York, he commenced 
practice in Chicago, and soon became well 
known as a skilful and sagacious specialist 
in eye diseases and eye surgery. As the local 
newspapers record, he had the enviable 
record of never once turning away a patient 
who was unable to pay for treatment. He 
was ophthalmologist to the Michael Reese 
and other hospitals, and a member of vari- 
ous local and national medical societies. 
To his subject he contributed a number of 
good papers, notable those on congenital 
sincipital encephalocele (1903), color per- 
ception in relation to distant signal lights 
(1904), the eye symptoms in myasthenia 
gravis (1905), rachitic erosions of the teeth 
in lamellar cataract (with I. A. Abt), and 
the schematic eye (1919). To Dr. Casey 
Wood's System of Ophthalmic Operations 
(191 1, 1, 17-41), he contributed a valuable 
illustrated historical article on representa- 
tive eye surgeons. 

In 1905, Dr. Frank turned his attention 
to the history of medicine and produced in 
succession, a series of excellent papers on 
the charlatan oculists, John Taylor (1905) 
and Sir William Read (1905), the Resur- 
rectionists (1907), Philip Syng Physick 
(191 1), Caricature in Medicine (1912), 



Medical Instruction in the Seventeenth 
Century (1915), Tagliacozzi (1916), the 
Discovery of the Secretory Glands, read 
before the Medical History Clubs of the 
Johns Hopkins and Harvard Universities 
(191 6), and the above mentioned paper on 
the Schematic Eye, contributed to the Osier 
Memorial Volumes (1919). 

In 1915, he became Secretary of the Chi- 
cago Society of Medical History, and editor 
of its Bulletin, which owes much of its im- 
provement in format and subject matter to 
his enterprise and good judgment. In the 
same year, he published at his own expense 
an elegant reprint of Henry Morley's Anat- 
omy in Long Clothes, for the Vesalian 
quadricentennial (1915). Dr. Frank was 
elected a member of the German Medical 
History Society (Leipzig) in 19 16. At the 
June Meeting of the American Medical 
Association in 191 8, he gave an exhibit of 
early medical books from his private li- 
brary, with a printed catalogue raisonne. 
In addition to outdoor sports, fishing and 
gardening, his personal tastes were in the 
direction of collecting rare medical books, 
fine bindings and medical engravings, and 
from these, he made many generous dona- 
tions to the Surgeon General's Library, 
which have been acknowledged in its Index 
Catalogue. In the last years of his life, Dr. 
Frank, through his exceptional flair and 
knowledge, acquired a choice and valuable 
collection of medical rarities, which went, 
after his death to the University of Chicago 
and the Surgeon General's Library. 

I first met Dr. Frank when he visited 
Washington in the summer of 19 15, in com- 
pany with Mr. Hoeber, and was struck at 
once with his refined manner, his clear intel- 
ligence, and his easy familiarity with the 
source and reference books of medical his- 
tory. Sometime after, he announced his 
intention of translating Choulant's History 
of Anatomical Illustration, which he com- 



Editorials 



207 



pleted in two years' time. In this task, he 
learned to know what hard work means. His 
performance, which includes a large amount 
of original research, is in every way credit- 
able. There was a genuine need for such a 
translation, since the original text, one of 
the classics of medical history, a vade 
mecum for anatomists, artists and medical 




Mortimer Frank (1874-1919). 

librarians, has been long since out of print. 
The publication of this history in 1852 was 
an affair of the right "psychological mo- 
ment," in the true and false meanings of 
the term; the circumstances which impelled 
Choulant to assemble his material, to shape 
it, and to publish it about the middle of his 
century, were equally fortunate. After this 
time, anatomical illustration by means of 
free hand drawings became merged into 



photography, lithography and other repro- 
ductive processes, and was further neglected 
through the growth of histology, mor- 
phology and embryology. Students now 
learn their anatomy by dissecting. Artists, 
who once, as Streeter has shown, outpaced 
the doctors in the dissection and delineation 
of anatomical structures, now copy directly 
from the nude body or the photograph. The 
merits of Choulant's book, then, are of a 
unique order. It is a key to the comprehen- 
sion of the older illustrated writings upon 
which the modern science of anatomy is 
based. The prosy, sesquipedalian, sometimes 
obscure sentences of the original, have been 
vivified and clarified in Frank's translation, 
by bisection, dissection and simplification, 
without any loss of the original meaning; the 
text has been enlarged by additional chap- 
ters, including a clear and exhaustive ac- 
count of Sudhoff's researches on the MS 
illustrations of the Middle Ages ; the bibliog- 
raphies have been extended and improved. 
When Choulant began his studies for this 
work, he had nothing to go on, beyond the 
scattered original texts. Haller's Biblio- 
theca Anatomica, Hain's list of incunabula, 
a few art catalogues, and the brief observa- 
tions of William Hunter and Blumenbach 
on the hand drawings of Leonardo da Vinci. 
The work is a monument of original re- 
search, not to be duplicated, a definite 
source book for the future, as well as for the 
present and the past. Frank's version con- 
verts it into a viable and readable modern 
book. 

Dr. Frank leaves a widow, Mrs. Dorie 
K. Frank, of Chicago, and two daughters. 

In person, Dr. Frank was a man of highly 
attractive and friendly character, generous, 
sportsmanlike, of unfailing good nature, 
and with the well-born gentleman's innate 
delicacy and sure intelligence, which wins 
esteem by respecting the personal rights and 
private feelings of others. His loss will be 
keenly felt by all whom he counted as 
friends. F. H. Garrison. 



208 



Annals of Medical History 
LORD LISTER 



In the present issue of the Annals we 
have the pleasure of presenting to our 
readers some personal reminiscences of the 
founder of modern surgery, from the gifted 
pen of one who knew him well and did 
much to further the propagation of his 
methods at a time when he was encounter- 
ing fierce opposition from those leaders 
of the profession who should have been 
foremost in at least studying and trying to 
understand the objects for which he strove. 
The article is timely in view of the com- 
paratively recent publication of the authori- 
tative biography of Lister by his nephew, 
Sir Rickman John Godlee. 1 Even though 
it appeared at the height of the great 
struggle, when all men's minds were 
occupied with the vital question as to what 
would be the outcome, the book created a 
diversion of thought, more especially as 
the lessons impressed on the minds of 
surgeons, and in fact of the laity, proved 
most clearly the eternal truths upon which 
Lister based his epoch-making labor. In 
reading it one is impressed with its likeness 
to the biography of another great scientist, 
who though not himself a medical man, 
did more to advance the science of medicine 
and surgery than any one man has ever 
done. We refer, of course, to the "Life of 
Pasteur," by Valery-Radot, and it is high 
praise of any biography to state that it 
stands comparison with that masterpiece 
of French literature. The books, in fact, 
present certain features of likeness to one 
another. Both are written by kinsmen of 
their respective subjects; both authors are 
clearly under the spell of the wonderful 
personalities of whom they write, and in 
the lives of both Pasteur and Lister we 
find many coincidences. Neither of them 
contain any startling adventures; their 
lives from some viewpoints would be con- 

1 "Lord Lister," by Sir Rickman John Godlee, Bt. 
London: Macmillan & Co. Ltd., 1918. 



sidered as rather destitute of exciting 
episodes or novel experiences, and yet if 
any more dramatic situations could be 
portrayed than those described in the lives 
of hard work and drudgery led by these two 
men we fail to imagine them. Both Valery- 
Radot and Godlee show their appreciation 
of the intensity of their struggles, of the 
obstacles they both had to encounter, 
where they should have been least led to 
expect them and the holy joy, the divine 
afflatus with which they were filled when 
they witnessed the triumph of their work 
over the narrow-minded and obstinate 
resistance which they had to overcome. 

Lister possessed certain advantages at 
the outset of his career. The offspring of 
parents in easy circumstances who afforded 
him every facility to pursue his chosen 
career, there is no doubt that he derived 
immeasurable benefit in his youth and 
early manhood from the scientific character 
and attainments of his father. His early 
association with Syme, the great Edinburgh 
surgeon, whose daughter he married, also 
aided him. Yet when he began the first 
investigations which, after lasting many 
years, culminated in the establishment 
of the principles not only of antiseptic but 
also of aseptic surgery, he had to labor 
single-handed and combat the incredulity, 
not only of his avowed opponents but 
even of some of those who wished him well. 

It is curious how prevalent the idea has 
become that Lister was a Scotchman, 
although he was born near London, studied 
medicine and received his M.B. at the 
University of London, and lived and prac- 
ticed in that city from 1876 until his retire- 
ment. This misconception arises from his 
long sojourns as a teacher of surgery in the 
cities of Edinburgh and Glasgow, a period 
extending from 1853 until his settlement 
in London. 

From the outset he made his mark as a 



La Societe Francaise d'Historie de la Medecine 



209 



teacher. His first efforts in this direction 
were in Edinburgh and were characterized 
by the care with which he prepared his 
lectures and the attention he bestowed on 
his students and patients. Strangely 
enough, throughout his life, in spite of 
carefully laid plans, notes, and prepara- 
tions, Lister seems always to have been 
terribly rushed to complete any address or 
lecture which he proposed giving when the 
time for delivering it arrived. One reason 
for this apparent unpunctuality may be 
found in the fact that his public utterances 
were almost always based on his own 
original research work, and as his ex- 
periments were continuously in operation 
he frequently held up a paper in order to 
finish experiments to be recorded in it. 
His laboratory work was conducted under 
the greatest difficulty. He had no separate, 
well-equipped room, with all the sup- 
posedly needful appliances. Much of his 
work was done in his own house, even in 
his consulting room. His researches led 
him into the fields of chemistry and 
cryptogamic botany, regions far afield from 
the engrossing labor of a most arduous 
surgical practice. He had to do considerable 
vivisection, and we trust that the letter 
which he wrote to Sir Henry Ponsonby, 
the Queen's private secretary, when re- 
quested by that functionary to make an 
authoritative statement "opposing" it will 
be widely read. It contains in a short 



summary the best and most logical state- 
ment of the benefits derived from vivisec- 
tion and of the foolishness of its opponents. 

The story of how his experiments and 
investigations ultimately led him to the 
formulation of the principles of antiseptic 
surgery is too long to enter into here. It 
should be read by every one in the pages of 
the volume we are now considering. The 
relationship of his labors to those of 
Pasteur are fully gone into, and the beautiful 
acknowledgment by each of these two 
truly great men of the value of the work 
of the other forms an instructive picture 
of the highest type of intellectual com- 
munity, of scientific aim and purpose. The 
great help Lady Lister accorded to her 
husband is touchingly recorded; and the 
various aspects of the hostility shown to 
Lister by his colleagues, sometimes from the 
inertia of conservatism, sometimes from 
pettier motives, is impartially described. 
Like most prophets his teachings received 
their most cordial reception elsewhere than 
among his fellow-countrymen. 

Now that he has passed away, his laurel 
wreath is nowhere more loudly acclaimed 
than in the localities wherein he at first met 
with his hardest rebuffs. The English 
medical profession is to be congratulated 
on its acquisition of this thoroughly 
adequate biography of one of its greatest 
surgeons. 

Francis R. Packard. 



LA SOCIETE FRANCAISE D'HISTORIE DE LA MEDECINE 



After an interruption of five years in its 
activities this distinguished organization 
has once more resumed its meetings. In no 
country has more genuine interest in the 
history of medicine been manifested by 
members of the profession than in France. 
The French historical school of medicine 
counts on its roll the names of many who 
have advanced our knowledge of the sub- 



ject and stimulated interest in its study. 
Daremberg, Littre, Deseimeris, Dariot, 
Renouard, by their researches and writings 
have laid the whole world under obligation. 
Cabanes has written many volumes on 
medico-historical subjects with verve and 
wit, and his study of Marat and other 
medical personages of historic renown are 
invaluable. Lucien Nass in his "Curiosites 



210 



Annals of Medical History 



Medico — Artistiques" anticipated the pon- 
derous tomes of Hollander. Chereau's medi- 
cal "Parnassus" is a splendid example of 
what should be done in other countries 
for the poetical love of the profession. The 
edition of Pare's complete works by Mal- 
gaigne with its invaluable historical intro- 
duction on the history of surgery, is one of 
the greatest treasures of medical literature. 
The memory of the great Pasteur has been 
embalmed in what is quite generally con- 



sidered one of the most beautifully written 
biographies ever penned. It is quite im- 
possible to attempt anything like an ade- 
quate summary of the services of the 
French medical historians to their confreres, 
but it is of world-wide interest that the 
Societe Francaise d'histoire de la Medecine 
has begun again its beneficial activities, 
and we wish it every success in the con- 
tinuance of its splendid national tradition. 
Francis R. Packard. 



EDITORIAL NOTE 



The Annals regrets that in the article 
"The Pulmotor of the Eighteenth Century" 
by Dr. J. Collins Warren, appearing on 
page 14, Volume II, Number 1, the legend 
which should have accompanied Fig. 4 
was erroneously placed under Fig. 1. This 
first illustration was taken from Scultetus, 
A.D., 1 67 1. As here correctly reproduced, 



Fig. 2 shows a man's head blowing smoke 
through a tube, the essential point of the 
illustration to which the author wished to 
direct attention. This portion of the illus- 
>. tration was accidentally omitted in the pre- 
vious reproduction. Similar apparatus is 
shown in Fig. 3 (Keil, A.D., 1747) which 
appears on page 19 of the same article. 




Fig. 2. Heister, A. D., 1750 



HISTORICAL NOTES 



EXHIBITIONS AT THE CLASSICAL ASSOCIATION 

In connection with the meeting of the 2. The life and work of the men who 

Classical Association under the Presidency made the original contributions? 

of Sir William Osier in May last at Oxford, "So far as concerns science and medicine, 

there was a Loan Exhibition of Early an attempt is made to answer the question 

Scientific Instruments, which it is to be by the collection of a Bibliotheca prima, 

hoped will serve as a stimulus for others of examples from which are here shown. The 

a similar kind. Oxford University is pecul- idea is to have in a comparatively small 

iarly fortunate in its possession of much number of works the essential literature 

material of this sort, particularly that in grouped about the men of the first rank, 

the Orrery Collection; but even in the arranged in chronological order. 

United States it would be possible to collect "I have put out the editiones principes of 

objects of the greatest interest, either from twenty of such works. The fundamental 

their antiquity or from the personal in- contribution may be represented by a great 

terest attached to them through their use by Aldine edition, e. g., Aristotle, by the brief 

famous investigators, or from their design. communication such as that of Darwin 

The exhibition at Oxford consisted chiefly and Wallace in the Proceedings oj the 

of astronomical, mathematical and physical Linnean Society, 1858, or by a three-page 

apparatus, but it contained also some pamphlet of Roentgen. 

notable microscopes. In America there is Plato 15 13 

too great a tendency to "junk" such articles; Hippocrates 1526 

but if efforts were made, there could be Aristotle 1495-8 

gathered at very slight expense, collections Theophrastus 1483 

for deposit in connection with our scientific Galen 1525 

and medical museums and libraries which Dioscorides 1499 

would help to visualize our scientific prog- Celsus 1478 

ress and stimulate our interest in its Plotinus 1492 

history. Rhazes 1476 

At the meeting, Sir William Osier also Avicenna i486 (not ed. pr.) 

presented what he termed "Illustrations Averrhoes 1473 

of an attempt to collect a Bibliotheca Copernicus 1543 

prima in Science and Medicine" which he Vesalius 1543 

explained in the following way: Agricola 1556 

"Faced with a bewildering variety and Gilbert 1600 

ever-increasing literature, how is the hard- Bacon 1620 

pressed student to learn Galileo 1632 

Harvey 1628 

1. The evolution of knowledge in any Descartes 1637 

subject, and Newton 1687 

211 



212 



Annals of Medical History 



The works given above are on exhibition. 

"From the card lists of Galen, Hippocrates, 
Vesalius, and Harvey, those interested will 
see the aim and scope of the collection." 

This is so splendid an example of the 
methods employed by Sir William to further 
scientific study and research that we feel it 
should be given the widest publicity in 



order to extend its sphere of usefulness. 
Elsewhere in this issue of the Annals some 
of the achievements of the greatest of living 
Anglo-Saxon physicians are dealt with. 
The present example shows that he is still 
seeking further opportunities to improve 
our knowledge of the foundations of our 
art. 



VOLUME II 




NUMBER 3 



? 



ANNALS 

MEDICAL 




S 



m 




?■ 



? 



FRANCIS R'PACKARD'M'D'EDITOR [PHILADELPHIA] J 
PUBLISHED QUARTERLY BY PAUL ? B ' HOEBER 
67-69 EAST FIFTY-NINTH STREET' NEW, YORK CITY 



£ 



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Entered u second class matter June a, 1017, at the post office at New York, N. Y., under the Act of March 3, 1879. 
Yearly Subscription $8.00. Single numbers I2.S0. 






CONTENTS OF VOLUME I 

NUMBER ONE 

The Scientific Position of Girolamo Fracastoro 1478? — 1553 

with Especial Reference to the Source, Character and 

Influence of His Theory of Infection . . Charles and Dorothea Singer 
The Greek Cult of the Dead and the Chthonian Deities in 

Ancient Medicine .... 

The Three Characters of a Physician 
Voltaire's Relation to Medicine 
An Unpublished Bronze Ecorche . 
Burke and Hare and the Psychology of Murder 
Hebrew Prayers for the Sick .... 
Laryngology and Otology in Colonial Times . 



Fielding H. Garrison 
Enricus Cordus 
. Pearce Bailey 
Edward Streeter 
Charles W. Burr 
C. D. Spivak 
Stanton A. Friedberg 



NUMBER TWO 



Eulogy of Dr. John Shaw Billings 

The Hygienic Idea and Its Manifestations in World History 

A Patronal Festival for Thomas Willis (1621-1675) with Re' 
marks by Sir William Osier, Bart., f.r.s. . 

Medicine and Mathematics in the Sixteenth Century 

Historical Development of our Knowledge of the Circulation 
and Its Disorders 

The Jetons of the Old Paris Academy of Medicine in the 
Numismatic Collection in the Army Medical Museum 
at Washington 

The History of Infection 

Text of William Shippen's First Draft of a Plan for the Organ- 
ization of the Military Hospital During the Revolution . 

The Beginnings of Intravenous Medication . . Horace 

The Legislative and Administrative History of the Medical 
Department of the United States Army During the Rev- 
olutionary Period (1776-1786) 



Abraham Jacobi 
. Karl Sudhoff 

Henry Viets 
David Eugene Smith 

Philip S. Roy 



Albert Alleman 
Arnold C Klebs 



Manchester Brown 



William O. Owen 



NUMBER THREE 

Figurations of Skeletal and Visceral Anatomy in the Books 

of Hours . . . Wilfrid M. de Voynich and Fielding H. Garrison 

Babylonian- Assyrian Medicine Morris Jastrow, Jr. 

On a Greek Charm Used in England in the Twelfth Century . . Charles Singer 
Military Sanitation in the 16th, 17th and 18th Centuries Charles L. Heizmann 

A Check List of Medical Incunabula in the Surgeon-General's Library 



NUMBER FOUR 

The First Printed Documents Relating to Modern Surgical 

Anaesthesia 

Byzantine Medical Fragments 

The New York Medical College 1782-1906 .... 
Studies in Paleopathology. I. Consideration of Evidences of 

Pathological Conditions Found Among Fossil Animals . 
Plague Tractates .... Dorothea Waley Singer and Reuben Levy 
The Medical Phrases of Victor Hugo .... Hubert Ashley Royster 



. William Osler 
. Charles Singer 
Abraham Jacobi 

. Roy L. Moodie 



ANNALS OF MEDICAL HISTORY 




Volume n 



Fall 1919 



Number 3 



ANCIENT POEMS ON INFANT HYGIENE 
By JOHN FOOTE, M.D. 

WASHINGTON, D. C. 




IDACTIC poetry, per- 
haps one of the earliest 
forms of verse, has be- 
come a rarity in mod- 
ern times, esteemed 
chiefly as a curiosity 
of literature. Indeed, 
some critics are posi- 
tive that the words didactic and poetry 
are of themselves so incompatible that 
no real poetry can be didactic. And 
yet, Hesiod, that shadowy rhymester, who 
seems as composite an individual as Homer 
himself, wrote the first didactic poems of 
which fragments have come down to us, 
and the elegant Aratus and Lucretius 
and Virgil followed in the footsteps of 
the rustic singers of ancient Greece. This 
could not fail to impress and influence 
those students who in later days read Greek 
and Roman literature. So it was that the 
intensive study of the old languages and 
the classical authors which came with 
the "revival of learning," and the prac- 
tice of writing Latin verses which was a 
fashionable affectation of erudition in 
the Renaissance period and later, caused 



a revival of the study and imitation of 
the ancient poems in European countries 
which influenced writers for at least two 
centuries. Indeed much didacticism is 
found in late eighteenth-century poetry; 
Pope was essentially a didactic poet. 

Like some primitive civilized peoples who 
put all their knowledge into verse, so that 
their learned men forgot nothing old yet 
originated nothing, these later didactic poets 
forgot little of the ancient learning, good or 
bad, and in their passion for precedent 
learned little that was new. Their scope was 
wide and versatile — they instructed the 
public in philosophy, astronomy, agricul- 
ture, religion and especially in medicine. 
Nauseous as the remedies of that day cer- 
tainly were, the prescriptions were sweet- 
ened and sugared with rhyme, so that no 
patient with a soul attuned to verse could 
well refuse them. There is, for example, the 
very ancient regimen of health of the 
University of Salerno, claimed by some to 
be as old as that venerable shrine of learn- 
ing itself — and conservatively placed as 
early as the thirteenth century — the equiv- 
alent of our modern books on personal 



213 



214 



Annals of Medical History 



hygiene. It is a little difficult to realize that 
people were interested in hygiene in that 
remote period — yet here is the proof. 

The eighteenth century witnessed a per- 
fect flood of medical didactic verse, some 
of the type of Garth's "The Dispensary," a 
poem which endeavored to reduce the ex- 
cessive charges of the apothecary — a very 
serious evil in that day. Not only were many 
English medical poems written at that time, 
but a fairly large number were translated 
from other languages into English. 

We are learning slowly enough that there 
is nothing very new under the sun, but we 
always mentally reserve certain ideas of the 
present day which are so peculiarly identi- 
fied in our minds with modern thought and 
modern progress as to constitute in them- 
selves a landmark between old times and 
modern days. One of these is the idea of 
educational propaganda by means of books 
and pamphlets to prevent infant mortality. 
Because of this it will come as something of 
a surprise to learn that in the didactic 
poetry of the eighteenth century at least 
two such treatises were translated into 
English from foreign languages — one, "The 
Nurse," 1 by Tansillo, from the Italian by 
Roscoe; the other, " Psedotrophia, or the 
Feeding and Uprearing of Children," 2 by 
St. Marthe, a French writer of Latin verse, 
translated by H. W. Tytler, M.D. "The 
Nurse" was printed in London in 1798 and 
reprinted in New York in 1800, while St. 
Marthe's poem was translated from the 
Latin into French, exhausted ten editions in 
its native tongue and was given two separate 
English translations, the last published in 
London in 1797. 

In 1776, more than two decades before 

1 Luigo Tansillo: "The Nurse," translated from 
the Italian by William Roscoe, Liverpool. London: 
1798. 

2 "Psedotrophia; or, the Art of Nursing and Rear- 
ing Children," translated from the Latin of Scevole 
de St. Marthe by H. W. Tytler, M.D. London: 
1797. 



either of these translations appeared, Dr. 
Hugh Downman, an English physician who 
dabbled in classic literature, wrote a didactic 
poem in his native tongue called "Infancy, 
or the Management of Children," 3 which 
went into seven editions. As a historical 
source it has little value as compared with 
the translations by Roscoe and Tytler, 
though it is probable that its publication 
may have stimulated interest in the foreign 
literature on the same subject. Throughout 
the six books the author seems more con- 
cerned with airing his classic lore than 
anything else, and the anxious mother 
would have a difficult time to remember his 
florid axioms, excellent though they were. 
Both Tansillo and St. Marthe expressed 
themselves both more succinctly and more 
wisely than Dr. Downman — because they 
really wrote for the mothers of their day. 
"Infancy" deals with breast feeding, acces- 
sory feeding, weaning, diet for older chil- 
dren, clothing and bathing, walking and 
exercise, and the simpler ailments. 

In the sixth book Dr. Downman pays a 
tribute to Lady Mary Montagu, and 
credits her with having established the prac- 
tice of inoculation to prevent smallpox. 
As this work was published in 1776, it pre- 
cedes Jenner's publication of vaccination by 
many years. Though the poet says inocula- 
tion has "saved thousands," he details no 
personal experiences with it. 

She hath been the cause 

Of heartfelt joy to thousands; thousands live 

And still shall live through her. . . . 

Yet Downman corroborates the state- 
ment of Klebs and others that inoculation 
against smallpox was widely used in Eng- 
land before vaccination was shown to be of 
greater value. There are so many apos- 
trophes to eminent physicians — Armstrong 
and Garth (the medical poets), CuIIen, 
Hunter, Mead, Hewson, Codrington and 

3 "Infancy, or the Management of Children," by 
Hugh Downman. Exeter: Trewman & Son, 1803. 
6th ed. 



Ancient Poems on Infant Hygiene 



215 



many others, to say nothing of long and 
intimate talks with Fame, Duty, Affection, 
Habit and many other qualities, virtues and 
vices, that the more one reads the more he 
is convinced that Downman was writing up 
to his literary and medical friends rather 
than down to the uninformed, or at least 
uninstructed mother of his day. This not 
only takes away from the author's original- 
ity but also from the vivacity of his narra- 
tive, in marked contrast with Tansillo, who 
ignored his contemporary physicians, or St. 
Marthe, who recognized them only for the 
purpose of confounding them. 

I. THE NURSE 

William Roscoe in his translation of Tan- 
sillo 's "La Balia," or "The Nurse," placed 
a scholastic chip on his shoulder by parallel- 
ing his translation with the original on the 
opposite page. Tansillo, born about 15 10, 
was by profession a soldier and by avocation 
a poet. He was a very good soldier, as his 
progress in the profession of arms attested, 
and his contemporary, Torquato Tasso, 
spoke of his sonnets as elegant, while Zeno 
averred that they would not suffer by com- 
parison with Petrarch's — proof enough, it 
would seem, of his poetic ability. "The 
Nurse" was not his only poem. Early in 
his career he wrote a dialogue in verse 
called "II Vendemmiatore," which, while 
admittedly witty, was generally condemned 
for its licentiousness, and indeed resulted 
later in having all of his works placed by 
Pope Pius IV on the "Index Expurga- 
torius." This was a very serious matter 
to any Italian author — as serious as the 
plight of a modern war correspondent who 
has fallen under the displeasure of the 
censor. Besides Tansillo seems to have been 
of really good character, and the interdic- 
tion hurt his reputation and his position. 

Chaste was my life, though wanton was my page 
Nor shall one blot deform my riper age. 

So he wrote in his apology which took the 
form of an ode to the Pope appealing for 



the removal of the ban on his writings. 
Whatever may have been the influence of 
this appeal Tansillo's works were not for- 
bidden in the next edition of the "Index." 

Besides "The Nurse," Tansillo wrote 
some comedies and a long didactic poem 
" II Podere"— "The Country House." His 
writings were long neglected and "The 
Nurse" was not published till 1767, two 
centuries after the author's death. 

We may safely assume from the context 
of this poem alone that Tansillo was a hus- 
band and a father. No mere bachelor could 
feel so strongly concerning the advantages 
of maternal breast-feeding as compared 
with the mental and physical dangers 
accompanying the practice of abandoning 
babies to the care of a wet nurse. The poem 
is, in fact, a pamphlet against an evil that 
at various periods of the world's history 
among the wealthier nations has engaged 
the attention of the philosopher and the 
propagandist. In Alexandrian Egypt, as in 
the Athens of Pericles, the Rome of the 
Caesars or the France of Louis XIV, and 
Elizabethan England — wherever and when- 
ever, in fact, wealth and luxury and artificial 
standards of fashion set their mark upon 
maternity — mothers have been in the habit 
of delegating the task of nursing the infant 
to foster mothers of a lower social order, 
and foster mothers have always been found 
venal enough to neglect their own babies in 
return for money and creature comforts. 
"The Nurse" is not only interesting as a 
document in the social history of Italy in 
the sixteenth century, but also because of 
its value to the medical historian in giving 
an authoritative retrospect of the practices 
and beliefs concerning wet-nursing main- 
tained during the period in which it was 
written. That these same practices and 
beliefs existed in England two hundred 
years later would seem incredible, if the 
translator did not naively inform us that 
such was the case. 4 

4 Luigo Tansillo: he. cit. 



2l6 



Annals of Medical History 



"Such is the coincidence between the 
state of manners in Italy in the sixteenth 
century and England in the eighteenth," he 
tells us, "that the translator though intend- 
ing to accommodate the poem to modern 
times has seldom found it expedient to vary 
from the original in the slightest degree." 

The practices of wet-nursing and baby- 
farming were notorious evils in seventeenth- 
and eighteenth-century England. Animal 
milk was not used in artificial feeding to any 
extent, not only because of the unsanitary 
conditions surrounding its production, but 
for other reasons. London in the sixteenth 
and seventeenth centuries was crowded and 
filthy — cows and other animals were often 
kept in noisome cellars. It was soon found 
that children fed on cow's milk died of "the 
watery gripes." The "Booke of Children," 
the first English nursing manual, written 
by Thomas Phayre (1551), and also the 
works of his successors, Walter Harris and 
John Pechy of the succeeding century, 
warned against the use of cow's milk. And 
so pap and Lisbon sugar and similar feeding 
adjuncts were employed, with or without 
breast milk, so that nutritional diseases 
were widespread and rickets came to be 
known on the continent as the English 
disease. For while Jacques Guillemeau de- 
scribed beading of the chest in infants in 
1609, it was the English physician, Glisson, 
who named and studied what he called "an 
absolutely new disease, rickets," publishing 
his classical study in 1650. The fashionable 
woman who wished to wean her infant, and 
there were many such, usually came to grief 
unless she could secure a wet nurse. As a 
natural result good wages were paid young 
country girls who had breast milk to sell. 
Moreover, these young women were un- 
usually well cared for and well fed so that 
their milk might be of good quality. The 
moral effect of this condition of affairs was 
pernicious. Large numbers of young women 
became mothers of illegitimate children 
which were immediately placed in baby- 



farms, while the mothers proceeded to dis- 
pose of themselves as wet nurses to more 
fortunate infants. The baby-farms had a 
tremendous mortality, as might be expect- 
ed, and as really was expected. This state 
of affairs became such a notorious evil in 
the eighteenth century that legislation was 
passed in an attempt to at least regulate if 
not control the conditions producing this 
tremendous mortality. From 1775 to 1796, 
99.6 per cent of 10,272 children admitted 
to the Dublin Foundling Hospital died. 
At about the same time the Paris Foundling 
Hospital had a mortality of over 80 per 
cent. And the private baby-farms were, if 
possible, worse than these public institu 
tions. 

Tansillo's poem was translated at abou 
this time, 1798, the year in which Jenne: 
announced his work on vaccination, an 
St. Marthe's was published the previou 
year. Both translations were undoubted! 
part of the propaganda for reform that w 
in the air concerning infant mortality an 
children's diseases. Underwood had jus 
written his text book, the first complet 
treatise in English, comprising not only 
consideration of children's diseases, but als 
completing the work on the care and nursin 
of the infants begun by Walter Harris in th 
preceding century and Cadogan in his ow 
day. George Armstrong too had written his 
"Essay on Nursing" and conducted his 
dispensary and small hospital for poor chil- 
dren in London where he spent time and 
money until lack of support forced him to 
close it. The translation of poems bearing on 
infant hygiene at this particular time can- 
not, therefore, be looked upon as a mere 
coincidence or an accidental happening. 

The practice of not nursing the infant 
indulged in by fashionable mothers was one 
of the evils which was prevalent in England 
in Roscoe's day as it was in Italy in Tan- 
sillo's. 

The poet refers to this tendency rather 
forcibly in the following: 



Ancient Poems on Infant Hygiene 



217 



What fury hostile to the human kind 
First led from Nature's path the female mind, 
Th' ingenuous sense by fashion's laws represt, 
And to a babe denied its mother's breast? 

Very early in the book the poet asks this 
question, which he rhetorically neglects to 
answer in his lyric fervor against the mother 
who takes every care of the embryo child 
only to refuse it natural care after it has 
come into the world: 

Hopeful that pity can by her be shewn 
Who for another's offspring quits her own. 

Most of the medicine of Tansillo's day 
was based on the works of Celsus, Galen, 
and other classical writers. It is not sur- 
prising, therefore, to discover that he has 
borrowed some of his ideas from the 
"Noctes Atticae" of Aulus Gellius. 5 The 
philosopher Favorinus holds forth in the 
"Attic Nights" on this very theme, in 
sentiments almost identical with Tansillo's. 
He also asserts the belief maintained by 
most ancient writers that milk and blood 
are practically identical substances, differ- 
ing only in color, and that premature check- 
ing of breast secretion must cause serious 
derangement of bodily functions. The trans- 
lator points to a similar quotation in Gellius 
and cites Nicolas Puzos, the famous French 
teacher of midwifery, in support of the view 
elaborated in the following stanzas: 

Check ye the milky fountain as it flows? 
Turn to a stagnant mass the circling flood 
And with disease contaminate the blood? 



O crime! with herbs and drugs of essence high 
The sacred fountains of the breast to dry, 
Pour back on Nature's self the balmy tide 
Which Nature's God for infancy supplied! 

There is really little difference between 
this practice and infanticide, says Favor- 
inus. 6 His Italian follower, is, if anything, 
more insistent. 

6 Aulus Gellius: "Noctes Atticae." (Beloe edition.) 
Book XII, i. London: 1795. 
6 Aulus Gellius: loc. cit. 



Social customs, even more than history, 
repeat themselves when certain favoring 
conditions are present. Kipling's "Judy 
O'Grady and the Colonel's lady" had really 
fewer points in common than the matron of 
Rome in the first century revealed when 
compared with the fashionable mother of 
London in the eighteenth. The ancient 
writers were nothing if not logical, whatever 
their premises may have been. And so, once 
admitting that milk and blood are identical, 
it would follow that any woman who can 
bear a baby can also nurse it. Tansillo puts 
this rather more elegantly: 

'Tis his, not hers — the color only changed 
Erstwhile through all the throbbing veins it ranged; 
Poured through each artery its redundant tide 
And with rich stream incipient life supplied. 

To shape and strength th' unconscious embryon 

grows 
But when 'tis born then Nature's secret force 
Gives to the circling stream another course. 

Probably in every age philosophers have 
ruminated on genetic problems of some sort 
or another. No one has ever quite satis- 
factorily explained the reason why animal 
pets increase in inverse ratio to the human 
birth rate. Plutarch records how Julius 
Caesar walking through Rome saw some 
strangers playing with lap dogs and mon- 
keys which they carried, and asked: "Do 
not their wives bear children?" As it was in 
Caesar's day so was it in Tansillo's; the 
sixteenth-century poet ridicules the meticu- 
lous care taken of these imported pets in the 
following passage: 

What fears ye feel as slow ye take your way 
Lest from your path the minion chance to stray, 
At home on cushions pillowed deep he lies. 



Whilst your young babe that from its mother's side 

No threats should sever and no force divide 

In hapless hour is banished far aloof 

Not only from your breast, but from your roof. 

The translator testifies to the existence 



2l8 



Annals of Medical History 



two hundred years later in eighteenth-cen- 
tury England of "this detestable custom . . . 
which is probably more frequent in Italy 
than in this country." That it was far from 
infrequent in England in Roscoe's day may 
be deduced from Hogarth's pictures — often 
showing a dog or a monkey as part of the 
furnishings of the fashionable drawing room 
of that period. Monkey parties are, however, 
not growing in popularity in modern society. 
Tansillo evidently had some misgivings 
as to the immediate effect of his propaganda, 
for he essays to give negative directions as 
to the proper procedure in choosing a wet 
nurse. Perhaps his knowledge of the medical 
classics was too strong even for his prej- 
udices. Ever since medical authorities 
learned to write, directions have been laid 
down as to the qualities which a wet nurse 
should or should not possess. Celsus had 
some ideas on the subject; Aylus Gellius 
made his wise character Favorinus discuss 
it. Soranus of Ephesus, who wrote in the 
second century, gave most sensible and 
explicit directions in his work on gynecology, 
while the Susruta Samhita, the great work 
on Indian medicine, which probably came 
later than the sixth century, devoted part 
of a chapter to its consideration. The 
weight of medical authority still lay heavy 
on the minds of men, and so Tansillo, imply- 
ing with a poetical shrug, "if you must, you 
must, though I have warned you," con- 
tinues : 

But if the pleasing task you still refuse 

Ah deaf alike to nature and the muse! 

Let prudence then th' important choice direct 

Nor let your offspring mourn a new neglect. 

To seek a nurse ye trace the country round 

At length the mercenary aid is found — 

Some wretch of vulgar birth and conduct frail; 

Some known offender, flagrant from the jail; 

In mind an idiot, or depraved of life, 

A shameless strumpet or impoverished wife; 

Or be she brown or black, or fresh, or fair, 

Or to the mother no resemblance bear, 

She brings, it seems, a full and flowing breast — 

Enough — your care excuses all the rest. 






It was undoubtedly Favorinus of the 
"Attic Nights" who supplied the poet with 
the foregoing argument, and he it was who 
originally emphasized the need of choosing 
a wet nurse of the same type and complexion 
as the child. For again, "since milk is 
blood" why could not physical and mental 
qualities be acquired through breast milk? 
That is why such emphasis is laid on "be 
she brown or black, or fresh, or fair," etc. 
Happily these fantastic beliefs have long 
ago passed into the oblivion of a thousand 
other speculative hypotheses of the past 
concerning human physiology. 

Avails it aught from whom the embryon sprung, 
What noble blood sustained th' imprisoned young, 
If, when the day-beam first salutes his eyes, 
His earliest wants a stranger breast supplies? 
From different veins a different nurture brings, 
Pollutes with streams impure the vital springs? 
Till every principle of nobler birth, 
Unblemished honor and ingenuous worth, 
Absorbed and lost, he falsifies his kind, 
A groveling being with a groveling mind. 

There is no uncertainty in the foregoing 
passage as to the belief — that mental and 
moral attributes were conveyed in the 
breast milk. 

In the second canto of the poem Tansillo 
speaks of prenatal care, and elucidates the 
old-time doctrine of longings, desires and 
frights and their influence in producing 
birthmarks and deformities. Old-time doc- 
trine it was and is — yet in many communi- 
ties today the belief that frights and un- 
satisfied desires may deform the unborn 
child still holds undisputed sway. The trans- 
lator, in a footnote, rejoices that "modern 
ideas have at length nearly banished an 
opinion formerly very prevalent and pro- 
ductive of great unhappiness to the female 
sex — namely that the child before its birth 
is liable to be partially affected by the 
imagination of the mother." The unhappi- 
ness of the poor male who had to gratify all 
manner of strange whims of a capricious 
wife under penalty of being held responsible 



Ancient Poems on Infant Hygiene 



219 



for some hideous deformity, might also have 
won the sympathy of the translator, who 
was himself a married man. Perhaps his 
undoubted gallantry restrained him from 
expressing his true sympathies ! 

The late eighteenth century was not 
wholly unprogressive, for a little later Roscoe 
says: "The absurd custom of binding down 
infants hand and foot with bandages .... 
has at length given away to the voice of 
reason and common sense." 

No woman of much character would 
deprive her own infant to nurse another, 
says the poet, and in a final outburst of 
indignation he exclaims: 

O past all human tolerance the curse, 
The endless torments of a hireling nurse! 
If to your children no regard were due 
For your own peace avoid the harpy crew; 
A race rapacious, who with ceaseless strife 
Disturb the stream of calm domestic life. 

Also, there is always the possibility that 
the infant may learn to love this impossible 
and unworthy foster mother more than the 
real parent, the poet argues, and then 
conjures up new perils : 

This can ye bear? Another curse awaits. 
Her tribe of followers besiege your gates, 
Brothers of doubtful kin and friends by dozens 
With female troops of sisters, aunts and cousins; 
Without reproof you hear their loud carouse, 
While frighted order abdicates your house. 

The dangers to her powers of lactation by 
the visits of lover or husband are spoken of 
with much more directness than poetry, 
and the possible disaster to the infant as a 
result of these visits is graphically depicted: 

Self her sole object — interest all her trade, 
And more perverse the more you want her aid; 
Sinks the poor babe without a hand to save 
And from the cradle steps into the grave. 

And the still greater physical danger from 
the loose moral standard of the wet nurse 
of his day, and the prevalence in that period 
of the most deadly of the so-called social 
diseases is thus emphasized: 



Say, is there one with human feeling fraught 
Can bear to think, nor sicken at the thought 
That whilst her babe, with unpolluted lips 
As nature asks, the vital fountain sips; 
Whilst yet its pure and sainted shrine within 
Rests the young mind, unconscious of a sin, 
He with his daily nutriment should drain 
That dread disease which fires the wanton's vein, 
Sent as the fiercest messenger of God, 
O'er lawless love to wave his scorpion rod? 

Again he reverts to the innumerable 
exactions of the wet nurse — citing as her 
prototype the wolf who nurtured the foun- 
ders of Rome, in contrast with the tender 
maternal care shown by Mary when : 

. . . . At a Saviour's birth 

With secret gladness throbbed the conscious earth, 

Whose fostering care his infant wants represt, 

Who laved his limbs, and hushed his cares to rest? 

— She, at whose look the proudest queen might hide 

Her gilded state, and mourn her humble pride. 

The plaints of nature outraged are em- 
phasized at some length and in the ensuing 
lines an appeal is made to young women 
newly married who expect to become 
mothers : 

Not half a mother, she, whose pride denies 
The streaming beverage to her infant's cries, 
Admits another in her rights to share, 
And trusts his nurture to a stranger's care. 

This passage, as well as much that pre- 
cedes it, was borrowed almost word for 
word from Aulus Gellius. 

Probably no difficulty existed in persuad- 
ing women of the lower classes in Italy to 
nurse their offspring. The chubby babies of 
the Italian Renaissance painters were just 
as certainly breast-fed, as some of the 
rachitic looking infants of the Bruges 
Master and other German and Flemish 
primitive painters were not. Frequently the 
pap bowl is seen in the Dutch, German and 
Flemish pictures of infants of that period — 
reason enough for their thin, weazened 
appearance. But it is to the great, fashion- 
able ladies of Italy that Tansillo appeals — 
witness his concludng stanzas devoted to 
an invocation to "Le Colonne, Ie Ursini, Ie 



220 



Annals of Medical History 



Gonsaghe — " all illustrious names. Not to 

be outdone, the translator interpolates 

a dedication to the Duchess of Devon- 
shire: 

Illustrious Devon led Brittania's train, 
And whilst by frigid fashion unreprest 
She to chaste transports opened all her breast, 
Joyed her loved babe its playful hands to twine 
Round her fair neck, or midst her locks divine 
And from the fount with every grace imbued 
Drank heavenly nectar, not terrestrial food. 

The Duchess was, undoubtedly, a con- 
spicuous example of maternal fidelity in a 
period when society women were allowed to 
believe and practice the belief that it was 
beneath their dignity to nurse their own 
children. But the observation of Tacitus 
concerning the care which women of the 
Germanic tribes, regardless of their tribal 
station, took in nursing their children, or 
the historic example of that Queen mother 
of France who snatched the infant prince 
from the arms of a lady in waiting who had 
presumed to nurse it, and going even 
farther thrust her royal fingers down the 
little prince's throat until he expelled the 
less noble milk — neither of these historic 
citations or examples found any repetitions 
in the maternal customs of the eighteenth 
century in the period of Roscoe, Pope, 
Hogarth and Underwood. And yet, Roscoe's 
translation of a poem two centuries defunct 
was not the only sign post of the trend of 
opinion in his day. There is other evidence 
that the English nation, aroused partly, no 
doubt, by the loss of life in the Napoleonic 
wars to the necessity for devising all possible 
means to preserve the national virility, was 
at last attempting to take seriously the 
problems of infant care and infant mor- 
tality, and was writing letters and pam- 
phlets, and — as we have seen — even poems, 
just as Englishmen in the past have always 
done, prior to going seriously into the 
correction of the evils, which they even- 
tually and quite definitely dispose of. 



II. P^DOTROPHIA 

Tansillo had been dead for about fifteen 
years and his poems almost forgotten when 
in 1584 Scevole de St. Marthe from his 
native city of Loudun, in France, wrote the 
dedication of Psedotrophia, a Latin poem 
on prenatal care and infant hygiene. He was 
distressed by the civil wars in his beloved 
country, and had just finished an extensive 
reading of ancient medical authorities, 
studied in an effort to assist in the cure of 
some ailment in one of his own children. He 
was at this time treasurer general of one of 
the provinces of France, "nevertheless" — 
as he said in his dedication to his royal 
patron, Henry III, "I have sought ac- 
quaintance with the muses," this acquaint- 
ance being utilized in the work of "pre- 
serving those young and tender plants 
against an infinite number of storms and 
tempests which menace and frequently 
destroy them as soon as born." The then 
rather novel doctrine that the crown or the 
state should be interested in the prevention 
of infant mortality is implied, rather timidly 
it is true, when he speaks of the power of 
the crown "not only over countries, cities, 
castles and other things inanimate, but also 
principally over many millions of souls, 
and of living persons, in the preservation of 
which Your Majesty has a notable interest; 
whether it be to serve in your Majesty's 
armies, or for letters, or for traffic, or other 
different occupations." 7 

Henry III, a weak, effeminate little man, 
the favorite son of Catherine de Medici, 
had ten years before this succeeded his 
brother, Charles IX, to the throne of 
France. In spite of his many weaknesses, 
however, Henry rivaled Francis I as a 
patron of art and literature, and he seems 
early to have recognized St. Marthe's 
ability not only as a scholar but as a states- 
man. William Butler Yeats enunciated in 
our own day the statement that only 

7 "Paedotrophia," loc. cit. 



Ancient Poems on Infant Hygiene 



221 



dreamers are practical. St. Marthe, whether 
or not he was a dreamer, was not only a poet 
of sorts but also at various times mayor of 
his city, representative at the Parlements 
of the kingdom held at Blois and Rouen and 
had, moreover, proven a telling factor in 
recovering for the king the province of 
Poitou after it had deserted to the League. 
A monument was erected to him by the 
States of Loudun in recognition of dis- 
tinguished services to his native city. Alto- 
gether he seems to have been a busy as well 
as an important man. An ample fortune and 
a wealthy marriage placed him beyond the 
need of noble patronage or royal favors. 

"Paedotrophia" was destined to see ten 
editions in the author's lifetime, was trans- 
lated from Latin into French and into ten 
foreign languages. It was given two English 
translations, the first dedicated to Dr. 
Garth, of which the second edition appeared 
in 1 71 8. The translation of 1797 by H. W. 
Tytler, M.D., was dedicated to the Earl of 
Buchan and sold by subscription. It was a 
very creditable literary effort and displays a 
spontaneity frequently missing in transla- 
tions. Tytler was not only a scholar after 
St. Marthe's heart, but an enthusiastic 
admirer of that poet, not hesitating to place 
Paedotrophia next in merit to the "Geor- 
gics" of Virgil as a specimen of didactic 
poetry. Besides, the translator was a phy- 
sician and all the more qualified to value 
the extraordinary knowledge displayed by 
this poet and statesman on the subjects of 
nursing and medical treatment. 

Again we meet quotations from Aulus 
Gellius, who was so much favored in Tan- 
sillo's poem, and Dr. Underwood's 8 new 
book is also referred to in the preface as the 
favored authority. Yet, it would seem that 
Van Swieten's "Aphorisms of Boerhaave" 9 

8 "A treatise on the Diseases of Children," by 
Michael Underwood. London: 1799. 4 tri e d- 

' Van Swieten : " Commentaries on the Aphorisms 
of Hermann Boerhaave." Translated by J. Kapton, 
el al. Edinburgh: 1776, vol. xviii, 80. 



influenced the editorial notes more than 
any other work on medicine and nursing. 

The book is dedicated to the author's 
wife, in a passage which contains some 
rather astonishingly frank compliments, 
recalling a warning expressed by the trans- 
lator in his preface, which reads: 

"If, after all the pains that have been 
taken, there may be still one or two pas- 
sages with which some nice young ladies 
will be apt to find fault, I would advise 
such to be sparing of their censures till they 
are married, and in a way to become 
mothers themselves; when it is not unlikely 
but they may peruse with the greatest 
benefit these very places which at present 
they will most readily condemn." . . . 

The purpose of the book, too, is expressed 
in St. Marthe's dedication to his wife — 
rather a fine passage: 

Accept my song, hence thy soft cares improve, 
And learn to nurse the pledges of our love; 
Lest, when pale Death demands us for his own, 
When iron slumbers press our bodies down, 
When our departing souls disperse in air, 
No son remain, no daughter's tender care 
To pay the funeral rites, the loss to mourn, 
And pour their tears on our neglected urn. 

Pliny, in Chapter ix of the twenty-eighth 
book of his "Natural History," says: "The 
mother's milk is the natural nourishment for 
infants." And Favorinus, the philosopher of 
Gellius, in whose mouth he puts so much 
wisdom, declares that the woman who does 
not nurse her baby is not "half a mother." 
St. Marthe had one or the other in mind 
when he wrote: 

A Sage declared, and with the speech I'm pleas'd, 
No mother should from nursing be released, 

The ancient doctrine that milk is meta- 
morphosed blood is again expressed: 

Besides since ev'ry milky fountain flows, 

By the same feed from which the foetus grows, 

What kinder nourishment could Nature give? 

By what so proper means could infants live, 

As from this sacred source to draw their food, 

And with their own, to mix their mother's blood? 



222 



Annals of Medical History 



"Nothing can be more natural or bene- 
ficial for the child," said Van Swieten, in 
Boerhaave's Aphorisms, 10 "than that it 
should be nourished by the milk of its 
mother. In the womb it had its nourishment 
and growth from the mother's humours; 
nay, it seems very probable, that, in the 
last month of pregnancy the milk was 
carried to the uterus and the foetus." 

Here in the poem, is the same idea: 

.... the fragrant spring 
The same that, ere his eyes beheld the day 
While yet imprisoned in the womb he lay, 
Was given by Nature for his earliest food, 
And filled his slender veins with circling blood. 
The dye just changes, when by winding ways 
Swift through the breast the vital current strays; 
Thro' glands pure white th' exulting juices flow 
Leave the firm red, and melt in tides of snow; 
Of milk, the colour and the name, they take 
But yet their ancient nature ne'er forsake. 

That snow-white colour too, most undefiled, 

Suits best the nature of an infant child, 

Who ne'er should tinge his tender jaws with blood, 

As if from recent slaughter came his food, 

Lest, from his early years, he should acquire 

A cruel heart and burn with impious fire. 

A discourse on prenatal precautions then 
follows with a poetic summary of the early 
signs and symptoms of pregnancy. The 
mother is enjoined not to emulate Gallic 
mothers and "gird too tight, the swelling 
waist," and to obtain plenty of sleep. 
Exercise too is prescribed, in moderation, 
as witness the following: 

Have you not seen from lakes and marshy ground 
The stagnant wave spread noxious vapours round, 
But running water, from the sparkling rill, 
Shines in the glass, and you with pleasure fill? 
The body, thus, from exercise, acquires 
New Health, new strength, and brisker vital fires. 

The "fair of France" come in for some 
criticism for the "modern dances" of that 
period which St. Marthe evidently disap- 
proves of — it was not so in the good old 
days, he says: 

10 Van Swieten: loc. cit. 



But these good times are o'er; each frisking dame 
Will dance as drunk, and lost in fear of shame. 

They hug the men; off their loose garments fly, 
Their naked beauties meet the wanton eye. 

In fact so vividly does St. Marthe describe 
this scene, that Tytler, being doubtless 
mindful of the "certain young ladies" 
whose anticipated criticism he so boastfully 
discounts in the preface, loses his courage 
and neglects to translate lines 303 and 304. 
Probably in extenuation, the translator 
appends a note, quoted from Smollett, criti- 
cising "the manner in which the ladies' 
faces are primed and painted." "From com- 
mon accounts of the manners of the French 
ladies, they would not seem to be much 
altered for the worse since the days of St. 
Marthe" says the worthy Dr. Tytler, triply 
damning them with the faintest praise. But 
this was written in a day when in the 
British Isles to decry anything French was 
considered almost a corporeal work of 
virtue. 

The diet of the expectant mother receives 
careful consideration from St. Marthe. Of 
course he does not call a pheasant a phea- 
sant — that would not be poetic. When he 
means a pheasant he says : 

That sweet bird which we from Phasis name. 

The patient either had to know her 
classics or — but he probably thought it did 
not matter what happened to anyone who 
was so ignorant. And yet, after all, is a menu 
that would have to be interpreted by means 
of a dictionary of mythology a bit more 
absurd than one written in modern table 
d'hote French — for which no kind of dic- 
tionary exists anywhere in the universe? 

Dr. Lemery, 11 a French physician of the 
eighteenth century, son of the chemist, who 
wrote a pharmacopoeia and discovered iron 
in human blood, was probably the leading 
authority of his century on diet. So when 

11 "Traite des Aliments," by Louis Lemery, 
Paris: 1702-1705. Translation, London: 1704. 



Ancient Poems on Infant Hygiene 



223 



St. Marthe commends as a food "Cytherea's 
dove" he distinctly means the turtle dove 
as distinguished from the wild pigeon. 
Those of melancholic habit should eat of 
pigeons rather sparingly, observed Dr. Lem- 
ery. He prefers that these individuals eat 
the young turtle dove, agreeing with Galen's 
observation that "it is a food neither too 
gross, nor too slight, and, in a word, very 
wholesome." 

Lemery, too, recommends the flesh of the 
young kid — still suckling — in contrast with 
St. Marthe, who says: "not till his horns are 
grown." Now these various recommenda- 
tions did not have as much to do with the 
digestibility of the proposed food, as with 
the effects of certain imaginary volatile 
principles — supposedly contained in the 
flesh of these animals — which were im- 
parted to those feeding on them. Thus 
Hippocrates, Aristotle and Plutarch all 
maintained that the flesh of the female goat 
differed from the meat of the male goat and 
should not be eaten by invalids. And to 
point a moral and adorn a tale the learned 
Dr. Lemery tells us how "a certain ancient 
wrestler of Thebes accustomed himself to 
live upon goat's flesh, and that he excelled 
all others of his time in strength; and this 
might be because the goat, being a lively, 
nimble and light animal, and consequently 
containing many exalted principles, com- 
municated those very volatile and active 
principles to him." 12 

We need not be surprised, therefore, at 
the minute, and to us somewhat absurd, 
directions regarding the kinds of food to be 
eaten, for they all had excellent authority 
for their promulgation. 

The strange and perverted appetite for 
unusual foods which some prospective 
mothers possess has from earliest times been 
noted and commented upon. Pliny called 
this condition malacia; Goraeus called it 
citta, from the Greek equivalent for mag- 
pie, possibly because these appetites are as 

12 Lemery, Louis: loc. cit. 



varied as the magpie's feathers — or because 
the magpie accumulates strange objects 
without any apparent reason for doing so. 
That there is danger in not gratifying these 
desires is another time-honored fallacy 
which is expounded graphically in the poem : 
The gastric fibres burn with fierce desire 
Of food, and oft unnat'ral meats require. 
Then (wonderful to tell) if you deny 
The strange request, nor with their wish comply, 
Avenging Nature, from unknown designs, 
With spots and marks the infant's body signs. 

And! (stranger still) while in the mother's breast 
This passion sways, and rages o'er the rest, 
Whatever place she scratches, or besmears 
A mark, in the same part, her infant bears. 
Hence, oft unseemly moles and freckles grow 
On virgin bosoms white besides as snow; 
O'er beauteous bodies veins and tumors steal 
And, for the mother's guilt, the daughters feel. 

Just where this belief in the origin of 
moles, blemishes and tumors through pre- 
natal influences arose is not clear; but there 
is no doubt that it is one of the most ancient 
and tenacious of the superstitions of medi- 
cine. 

The ensuing paragraphs deal with the 
preparations of the mother for labor and 
her conduct during that ordeal. An episode 
describing the Garden of Eden then follows, 
and the eating of the forbidden apple by 
Eve is pictured: 

She ate, she gluttoned on the food, possest 
With all the longings of a female breast, 
And thus, betrayed by her impure desire 
Began what pregnant mothers yet require. 

The origin of the longings and the pains 
of labor is given in this way an explanation 
probably as rational as any other which 
could be attempted. It was an original idea, 
in a way, for up to this time the wonderful 
story of Genesis had not been told in heroic 
poetry, much as it was favored by the 
primitive painters. Milton was yet to write 
his "Paradise Lost" — and it is not only 
possible but probable that he read St. 
Marthe's poem, even if he did not profit 
by it. 



224 



Annals oj Medical History 



The second book of " Psedotrophia" treats 
of the management of healthy children from 
birth to the time of weaning. No mention is 
made of artificial feeding excepting as 
supplementary to breast milk. The danger 
of keeping children too warm and excluding 
the external air is a point dwelt upon with 
emphasis by the writer. Directions are 
given as to the preparation of the mother's 
bed and the infant's cradle. Van Swieten 
explained the desire of the child for the 
motion of the cradle by a prenatal habit of 
the unborn acquired as a result of having 
been shaken "this way and that while the 
mother moves her body." 13 Moschion, too, 
gave specific directions about the cradle, 
advocating the type "swinging from ropes." 

There are rather minute directions to the 
midwife, particularly regarding the proper 
procedure in Iigating the cord: 

With dust of mastich sweet take care to stir 
The finest powder of more fragrant myrrh; 
Let this united fill the recent wound, 
And with soft wool the shorten'd cord be bound. 

In Van Swieten's day hemostatic sub- 
stances such as myrrh were not used. Among 
the "Aphorisms" he quotes the French 
surgeon, Levret, who advises against either 
binding or cutting the umbilical cord until 
the child has breathed, and urges that the 
amputation be made not too near the um- 
bilicus. 14 

The prognosis of the infant based on its 
cry occupies a small portion of the "Papyrus 
Ebers" — the oldest written manuscript on 
medicine. It seems almost incredible that a 
medical superstition of this type should sur- 
vive since the day when Moses was a young 
man, but if it did not survive it curiously 
reappears in the sixteenth century. Witness 
the following: 

'Tis useful too t' observe, with cautious eye, 
The signs, on which all prudent minds rely, 
That may foretell long life, or early death, 
To the young infant, just endowed with breath, 
From languid cries, one knows not to express 
But you their meaning, by experience, guess. 
13 Van Swieten: loc. cit. u Idem. 



The danger of exposing the newborn 
infant to cold air — a very important point — 
and one still adhered to, is dwelt upon, as 
well as the necessity for avoiding extreme 
heat in summer. Soranus laid down these 
same principles in the second century, and 
they are found in the Indian Susruta. The 
resuscitation of the child that does not 
breathe properly is discussed and St. Marthe 
recommends the use of wine internally, 
and blowing into the child's nostrils. The 
editor quotes Dr. Underwood, who advo- 
cates blowing into the infant's mouth 
rather than its nostrils. 

Bathing is next discussed. St. Marthe 
decries the practice of bathing the infant in 
cold water, comparing it to the custom 
described by Tacitus among the barbarous 
Germanic tribes, of plunging the newborn 
baby in the icy Rhine as a test of hardihood. 
In this passage, the translator again quotes 
Underwood in deprecation of cold bathing 
of the newborn which he characterizes as 
"savoring of unnecessary severity." That 
it was the practice to wash the newborn in 
cold water even in the middle of winter is 
attested by Underwood who describes just 
such a scene in which the infant is "itself 
in one continued scream, and the fond 
mother covering her ears under the bed 
clothes that she may not be distressed by 
its cries." St. Marthe does not approve of 
this ancient German practice — 

But you forbear, what fame reports of old 
The Germans used, a race inured to cold, 
To war, to labour from the cradle bred, 
And like themselves the infants fared and fed, 
The newborn child, yet reeking from the womb 
They took to what oft gave him to the tomb; 
Lest he should from his father's strength decline 
They plung'd him shiv'ring in the freezing Rhine. 

After bathing the child in warm water 
perfumed with musk, it is advised that the 
infant's limbs be examined for deformities 
which if found should be corrected at once. 
From earliest times, among all the nations 
of antiquity except the Egyptians and the 



Ancient Poems on Infant Hygiene 



225 



Spartan Greeks, the practice of swaddling 
was utilized because of a supposed necessity 
for keeping straight the limbs of the infant 
presumably cramped in a curved position 
for a long period before birth. Salting, that 
is, rubbing the newborn with salt, was also 
practiced. Galen and the ancient writers 
advised this procedure, possibly to help in 
removing the greasy covering of the skin of 
the newborn. Both of these time-honored 
customs are described and commended in 
this poem. Dr. Tytler, however, in his com- 
mentary tells us that "the aintient mathod 
of swathing children with tight bandages is 
now justly laid aside." 

Little food is needed at first, says the 
poet. The ancients of Greece and Rome 
used honey and water as the first food of the 
baby. Soranus said that no other food 
should be given for forty-eight hours after 
birth. This, too, St. Marthe approves of, 
saying: 

No sugar is so good, no fruit so fine 
No milk so rich, nor nectar more divine. 

Narbonne honey is the especial variety 
endorsed by the poet. Dr. Lemery also 
praises Narbonne honey because, he says, it 
is largely made from rosemary flowers. 
Honey was the sugar of the ancients : Virgil 
called it "celeste donum," and Pliny "divi- 
num nectar." Pythagoras, who lived to be 
ninety, attributed his long life to the liberal 
use of honey, while Pliny relates how one 
Vedius PoIIio.who lived to be one hundred, 
told the Emperor Augustus that he had 
retained vigor and years by the use of honey 
within and oil without. As a matter of fact, 
honey containing a readily digested sugar 
was very well adapted to the purpose for 
which it was used in the infant feeding of 
antiquity. 

St. Marthe believed in fresh air and com- 
bated the tendency found even today in 
France, of keeping infants in close, illy 
ventilated rooms : 



Misguided fondness make our nurses err 
By heating infants and excluding air. 

Not a very good rhyme, but a very good 
idea. He relates at length the tragic death 
of the son of Francis II, duke of Brittany, 
which he attributes to this custom. The 
pernicious practice of treating acute fevers 
such as smallpox with heat and exclusion 
of air survived for many generations after 
this poem was written, and it is certain 
that St. Marthe's innovation was severely 
criticized by the physicians of his day. 

The practice of wet-nursing is roundly 
condemned by the poet, as well as the cus- 
tom of feeding other things than the 
mother's milk. Van Swieten writes of the 
virtues of the first thin milk of the mother 
and quotes Munro, the great Scottish phy- 
sician, in corroboration. The use of pap 
made from milk, or broth, Van Swieten 
condemns as being "altogether unfit" at 
this time. "A few hours before," he says, 
speaking of the infant, "it lived upon its 
mother's humours; humours of like nature 
are ready in the breasts, prepared in the 
mother's body." 

Like Tansillo, St. Marthe adds some 
directions as to the choice of a wet nurse. 
A test for the quality of breast milk is also 
given — the finger-nail test. 

Avoid what on your nail too ropy proves 
Adheres too fast or thence too quickly moves. 

Who first described this test? It is found 
in Soranus' text book in the second century 
and its very simplicity probably made it 
survive the assaults of time. 

A proper regimen for the nursing mother 
is prescribed by St. Marthe. Fresh air is 
again praised, and exercise in the open 
where there is sunlight. Occupancy with 
household tasks, too, is urged as wholesome 
and even necessary. The technique of nurs- 
ing is described — including the necessity for 
cleanliness, frequent washing and the re- 
moval of the first milk. And here is sensible 
advice as to the quantity of food: 



226 



Annals of Medical History 



Think well, beside, what his young frame may bear, 
For, strong or weak must different methods rear, 
If healthy, copious nourishment is good 
If sick or feeble, spare the grateful food. 

During dentition he warns against feed- 
ing the child too much, and advises giving 
solid food only after the teeth have come. 
But he also counsels : 

Be light and easy still what e'er he eat. 

A list of undesirable foods is given, in- 
cluding sweets, meat and other "heavy 
viands." Some quite modern directions 
follow: 

When now you change, and give but half the breast, 
Food most resembling milk is still the best; 

Hence nurses give, nor shall the Muse dissuade 
Broth by itself, or often mixed with bread. 

Flour, meal and cereal gruels are also 
described as appropriate foods. Modern 
mothers might well heed the following: 

But trust not always to his infant cry 

Which not from thirst or hunger constant springs, 

But oft from gripes that indigestion brings. 

Wherefore at proper times twixt ev'ry meal 
Observe if his distended belly swell; . . . 
Then, tho' continued cries declare his need 
Obey the symptoms and forebear to feed. 

This, of course, is far from lyrical and let 
us hope that it glided more smoothly in the 
original tongue; but it is splendid hygiene. 

Let the baby cry a little, says St. Marthe 
— doubtless thereby acquiring the rancor of 
every grandmother who could read in six- 
teenth-century France. Yet he continues: 

And moderate cryings come oft not in vain 
They stir a dull and cleanse a watery brain. 

It was believed by some later writers, at 
least, that tears literally cleared the brain. 
James Primerose in his "De Morbis Puero- 
rum," 15 published about a century after 

16 James Primerose :"De Morbis Puerorum. "Also in 
"Contributions to Medical and Biological Research 
Dedicated to Sir William Osier, Bart.,M.D., F.R.S." 



"Psedotrophia," may have taken St. Marthe's 
statement literally, or possibly had earlier 
authority for the dictum that "tears are 
serous Humors which the brain discharges 
through the eye." Here was a real ana- 
tomical basis for the propriety of crying. 
No poet of the sixteenth or seventeenth 
century in the face of this could speak of 
tears as "idle tears," or say "I know not 
what they mean." 

Daily bathing is prescribed, and again 
fresh air. 

Amuse him often with some blithesome tale 
And take him out to breathe the balmy gale, 
When air is pure, when clouds, when vapours fly, 
And favouring west winds sport along the sky. 

The mother should nurse the child, partly 
or wholly when possible, for two years, St. 
Marthe declares. The period of breast-feed- 
ing has apparently steadily been growing 
shorter. In St. Marthe's day the average 
was two years, while in Tytler's time, two 
centuries later, it had contracted to six 
months. Underwood proposed one year as 
the proper period — provided the child has 
good digestion and has cut at least four 
teeth. Today it is nine months. Directions 
for weaning — mostly quite sensible direc- 
tions — are given, and there are numerous 
annotations from Underwood by the trans- 
lator. 

The second book of the poem closes with 
a description of the civil wars of France 
under Charles IX, and an elegy to the 
memory of St. Marthe's friend, "Damon," 
who was killed in the civil strife. "The 
original," says the translator, "may be com- 
pared with the finest parts of Ovid." 
Whatever the style may have been in the 
original Latin, there can be no doubt that 
the poem itself was an admirable adventure 

New York: Paul B. Hoeber, 19 19, vol. i, 177, 
"Some Seventeenth Century Writings on Diseases of 
Children" by George F. Still; and "The History of 
Infant Feeding from Elizabethan Times," Proc. 
Roy. Soc. Med., Lond. 1910-11, vol. iv, 1 10-140. 



Ancient Poems on Infant Hygiene 



227 



into preventive medicine, displaying a great 
deal of common sense and freedom of 
thought on a subject which the author found 
overgrown with absurd tradition. 

The third book of " Pantatrophia" deals 
with the treatment of diseases of infants. 
While his hygiene was excellent, so much 
cannot be said for St. Marthe's diagnosis 
and treatment. 

Among the disorders treated are thrush, 
ranula, teething, indigestion, worms, erup- 
tions, smallpox and epilepsy. Smallpox, 
which evidently existed in the poet's family, 
should not be treated by sweating and ex- 
clusion of the air — such is the rather revo- 
lutionary statement which he makes. Ap- 
parently this good advice was little heeded 
by succeeding generations since the treat- 
ment of fevers by heat, starvation and ex- 
clusion of air and light continued for full 
three centuries. 

Of course we laugh at the therapeutics 
of the past — just as future generations will 
laugh at our remedies. Even at this date, 
however, we have not greatly improved the 
treatment of certain conditions. Lack of 
intestinal action was treated in the infant 
of St. Marthe's time by the administration 
of honey. The suppository made from the 
root of the mallow was also used in obstinate 
cases. Intestinal parasites in children are 
treated today with santonine, the active 
principle of santonica or wormseed. Yet 
wormseed was the remedy used in the six- 
teenth century, and even before that time. 

Use chief the chaffy seed, renowned in fame 
That from the worms itself derives its name . . . 
This proves a certain cure, nor need I mind 
What other we from old physicians find. 

For epilepsy mistletoe was recommended 
— and no doubt was quite as effectual as 
many of our more modern remedies, which 
is really not overpraising it. Less useful 
was another remedy suggested: 

Or burn a human skull to ashes white 
And with fine powder of those horns unite 
That from the heads of deer like branches come 
And add the fragrance of Arabian gum. 



And yet, the use of remedies such as the 
foregoing was so general in his day, that it 
is a tribute to the poet's good sense that he 
did not endorse a greater number of them. 

"Paedotrophia" ends with a pious invoca- 
tion and a wish that the desire of King 
Henry for an heir should be granted — a 
wish that no doubt brought the poet much 
favor. 

All in all, these ancient poets did a good 
work, sowing in the ages long past the seeds 
that developed in our modern work in infant 
welfare. While there are many things in 
these verses that violate all the proprieties 
of poetry and the canons of lyric art — many 
passages even ludicrous to the modern 
reader, yet in the spirit of such composi- 
tions there is much to praise, much to 
endorse and, in all fairness be it said, sur- 
prisingly little to actually condemn in the 
nursing technique which they taught, or 
hoped to teach to the mothers of their day 
and age. And they are especially useful to 
the student of the history of the nursing 
art, since they were written in a period 
when the physician affected to consider 
the care of the child and its nursing a matter 
for midwives alone, in fact, the subject was 
thought to be rather beneath the doctor's 
dignity. Even the earlier textbooks on 
diseases of children seem to apologize for 
introducing matter relating to nursing. So 
it was that these popular nursing manuals of 
the sixteenth century were written by lay- 
men for the use of the laity, and contained 
much information not available in the medi- 
cal textbooks. Buchan, in the second edition 
of Armstrong's work, quotes John Hunter 
as saying: "Nothing can be done for sick 
children." Whether or not Hunter actually 
made this remark, in his day the medical 
profession acted as if they believed it; and 
so the initiative in infant hygiene propa- 
ganda as exemplified in these old verses of 
the sixteenth century should be credited to 
the singers of songs rather than to the 
prescribers of pills and potions. 



WALTER HARRIS, A SEVENTEENTH-CENTURY PEDIATRIST 



By JOHN RUHRAH, M.D., 

BALTIMORE, MD. 



PEDIATRICS is a modern specialty, 
and the practitioner or investiga- 
tor devoting his whole time and 
energy to the study of the diseases 
of infants and children is inclined to think 
our knowledge of the subject a thing 
belonging to the very end of the nineteenth 
century and to the twentieth. Payne has 
very aptly styled the present era "the Age 
of the Child." It is interesting, therefore, 
to look backward over the centuries and 
try to see what the medical men of other 
times thought or knew about morbid mani- 
festations in the young. Garrison has given 
a delightful account of the history of 
pediatrics (soon to appear), to which the 
writer owes any knowledge he may have 
of the subject; and he is indebted to the 
same generous donor for the stimulus and 
the opportunity to study the books of the 
early writers. 

Children were not entirely neglected by 
the ancients; Hippocrates and Soranus in 
the olden days, Avicenna and Rhazes later, 
and in mediaeval times Metlinger, Bogel- 
Iardus and Roelants (the last better known 
under the name of Austrius, who appro- 
priated his writings with scant acknowledg- 
ment), all devoted a certain amount of 
attention to the little understood subject, 
writing either separate treatises or including 
material dealing with children in their 
works. Then came Felix Wiirtz, a delightful 
old character of Basle, a surgeon who wrote 
down what he saw or believed, and pro- 
duced one of the first contributions to 
pediatrics based on personal observation 
and not on academic discussion. After 
Wiirtz came Walter Harris, a pupil of the 
doughty Sydenham, the master who is said 
to have advised him to study Don Quixote 
as a preparation for the study of medicine ; 
a jest which the great master is also said to 



have made to Richard Blackmore, and per- 
haps truly, as even in these days, we know 
how a prosperous saying will be used over 
and over again. We may suspect the 
worthy old doctor of something of the same 
spirit in the remark he made about Harris' 
book, which Harris takes great pains to 
quote: 

"I might add, and positively affirm, 
that the same excellent Author, after he 
had vouchsafed to read the first Edition 
of this Book, was pleased, out of his great 
good Nature, to speak to me in the fol- 
lowing Words: 'I never flatter any Man, 
nor shall I flatter you, when I tell you, 
that I never before saw any Book that I 
had Reason to envy. For in Truth, I 
think your little Book may be of more 
Service to the Publick, than all my own 
writings.' I do not mention this from any 
Principle of Vanity, Self-Love, or ill 
Design, but as it were from the Impulse 
of some hidden Reason. For of what Use 
is Flattery, or vain popular Applause in 
an advanced Age? Or what can an un- 
deserved Commendation signify to 
Man, who is just leaving the Vanities of 
this World?" 

Of Harris' life we know but little. The 
"Roll of the Royal College of Physicians" 
furnishes nearly all the biographical informa- 
tion which we possess. Short accounts are also 
given in Haeser's "History of Medicine," 
by Norman Moore in the "Dictionary of 
National Biography," and there are a few 
notes here and there in some of the various 
collections of medical biography, such as 
Bayle and Thillaye or Jourdain. 

Harris was born in 1647, at Gloucester, 
England.^ He was sent to Winchester 

1 Hirsch gives the date as 1 65 1 , but this is doubt- 
less an error. 



228 



Walter Harris, a Seventeenth-Century Pediatrist 



229 



School and from there to New College, 
Oxford, where he received his degree of 
B. A. on October 10, 1670. He then changed 
his creed to become a Roman Catholic, and 
resigning his fellowship journeyed to France, 
where he studied medicine, finally taking 
his doctor's degree at Bourges on July 20, 
1675. In the following year he returned to 
London. In 1678, in consequence of the 
Oates plot, all Roman Catholics were 
ordered to leave the metropolis. This caused 
Harris to recant. He left the Church, pub- 
lishing an article entitled "A Farewell to 
Popery." In the following year, 1679, he 
received his doctor's degree from Cam- 
bridge, and on April 5, 1680, became a 
candidate of the College of Physicians, 
being one of the censors in 1688, 1698, 1700, 
1704 and 1714. He was treasurer from 1714 
to 1717 and consilius from 171 1 until the 
time of his death. 

In 1 58 1, in the twenty-fourth year of the 
reign of Queen Elizabeth, Richard Cald- 
well, M.D., a fellow of the Royal College 
of Physicians, and Lord Lumley, founded 
a surgical lectureship and endowed it with 
fifty pounds a year, laid as a rent charge 
upon the lands of Dr. Caldwell and Lord 
Lumley. The early lecturers were appointed 
for life, but later on the period was changed 
to five years, and since 1825, the lecturer 
has been nominated annually, but generally 
two years in succession. The Lumleian 
lectureship was held by distinguished phy- 
sicians; but strangely enough, most of their 
names are not familiar. William Harvey 
expounded his views on the circulation as 
Lumleian lecturer in 1616. Richard Bright 
held the position in 1837. It is pleasing to 
note that Walter Harris was appointed in 
1 710, and held the position until his death 
on August 1, 1732. In 171 1, he lectured on 
"De Ossibus Capitis," in 17 14, on "Phleg- 
mon," in 1 7 15, "De Ersipelate et de Morbis 
Cutaneis," and in 1716, "De Febribus." 

Another honor accorded Harris was deliv- 
ering the Harveian oration on several occa- 



sions. This lectureship was founded by 
Harvey himself, who conveyed his patri- 
monial estate of Burmarsh to the college. 
This was left to promote friendship; once a 
month a collation was provided for such as 
came, "and once every year a general feast 
for all the fellows: and on the day when 
such feast shall be kept, some one person 
of the College . . . shall make an oration 
in Latin publicly." Harris delivered orations 
in 1699, 1707, 1 713, and 1726; that of 1707 
was printed. 

In passing, one might comment on this 
pleasant custom of breaking bread together, 
one of the best ways of getting acquainted 
and fallen too much into disuse by the 
modern medical societies. 

As a physician Harris was a pronounced 
success, and enjoyed a large and fashionable 
practice in the gay whirl when good Prince 
Charlie reigned as Charles II. Then came 
the Revolution, and on the recommendation 
of Archbishop Tillotson he was made phy- 
sician to King William. These connections 
brought him into greater prominence and 
he enjoyed an intimate acquaintance with 
royalty, as King William took him to Hol- 
land on one of his campaigns, and their 
discussions on the absorbing topic of garden- 
ing led to Harris' publishing a description 
of the King's Palace and Gardens at Loo. 

In 1694, Queen Mary caught smallpox, 
which developed into the hemorrhagic 
variety, and she died on the eighth day. 
Harris sat up with her on the sixth day of 
the disease. This case of smallpox led to 
some difference of opinion and involved 
the famous and thoroughly delightful John 
Radcliffe, three years younger than Harris, 
and at the time physician to the Princess 
Anne. According to Bishop Burnet, Rad- 
cliffe was regarded as negligent and unskill- 
ful and he was blamed for the Queen's 
death. He himself, however, thought dif- 
ferently and stated that "her majesty was 
a dead woman, for it was impossible to do 
any good in her case, when remedies had 



230 



Annals of Medical History 



been given that were so contrary to the 
nature of the distemper; yet he would en- 
deavour to do all that lay in his power to 
give her ease." Harris was among those 
present at the necropsy. One cannot pass 
Radcliffe by without quoting the well- 
known anecdote of that sharp-tongued 
physician: "In 1699, King William, after 
his return from Holland, sent for Radcliffe, 
and, showing him his swollen ankles, while 
the rest of his body was emaciated, said — 
'What think you of these?' 'Why truly,' 
replied Radcliffe, 'I would not have your 
Majesty's two legs for your three king- 
doms'." 

As to Queen Mary's case, Harris himself 
attributes her death to her taking the 
advice of Dr. Richard Lower, given years 
before. Lower advised the Queen, when she 
was indisposed, to take a large quantity of 
Venice treacle on going to bed and so pro- 
mote sweating. About two years before 
her fatal smallpox, she told Harris of this 
and he advised against the practice, warn- 
ing her that "your Majesty will some time 
or other undergo an extreme Hazard of your 
Life from a Medicine so intensely hot, 
whensoever you shall be seized by a per- 
manent and continued Fever." He goes on 
to relate: 

"However, this justly admired Queen, 
forgetting all that I had said, and fixing 
the famous Lower's Advice firmly in her 
Memory, was pleased, at the first Attack 
of the Small-pox, to take Venice Treacle 
the first Evening, and finding no Sweat 
appear as usual, she took the next Morn- 
ing a double Quantity of it, to throw out 
a Sweat in vain, before she asked the 
Advice of the Physicians. Thus it pleased 
the most wise Governor of all things, 
suddenly to translate the best of Queens 
from her unworthy People into Heaven. 
Never was any Mortal bewailed with so 
many Tears, such sincere Lamentations, 
and such universal Sorrow, not even the 



most beloved Parent by the most darling 
Child. For not only the Loss of the 
Queen was deplored, but the Ruin also 
and Destruction of the whole Kingdom 
was at that Time apprehended. But the 
vehement Grief which the Remembrance 
of so great a Calamity always renews, is 
much lessened to me, when I recollect 
that I pointed out the Rocks on which 
she was cast away, and admonished her 
of the future Danger." 

He continues with an account of Her 
Majesty's fatal illness of which he gives a 
graphic description. 

Harris was the author of a number of 
works, for the most part containing the 
substance of his lectures at the College of 
Physicians. The following list is given in the 
"Roll of the Royal College of Physicians" : 

Pharmacologia Anti-Empirica; or, a 
Rational Discourse of Remedies, both 
Chemical and Galenical. 8vo. London, 
1683. 

De Morbis Acutis Infantum. 8vo. Am- 
sterdam, 1698. 

De Morbis aliquot Gravioribus Observa- 
tiones. 8vo. London, 1720. 

De Peste Dissertatio, cui accessit De- 
scriptio Inoculationis Variolarum. London, 
1721. 

Dissertationes Medicae et Chirugica?. 8vo. 
London, 1725. 

Following the account of the diseases of 
children in the English translation are some 
seventy-nine pages entitled: "Book the 
second. Containing Observations on several 
grievous Diseases." He begins: 

"I have thought it not improper to add 
a few Cures of grievous Diseases, which 
perhaps will not be very displeasing, and 
not altogether unprofitable to the Reader. 
If I relate but few Observations, there 
will be the less waste of Time, and the 
Reader will not spend many good Hours 
idly. Let others, who love a commendable 
Leisure, or who have immense Treasures 



Walter Harris, a Seventeenth-Century Pediatrist 



231 



of Science, or who can as easily root out 
any Diseases, as kill Flies, or tell Stories, 
let such furnish out a Medical Banquet, 
furnished with a sufficient Number of 
Observations, to satisfy the voracious 
Appetite of the most greedy after Learn- 
ing. A frugal and philosophical Repast is 
at present sufficient for the Narrowness 
of my Circumstances. Nor is a sober and 
sparing Table to be quite despised, 
especially by Physicians, who are used to 
impose a Rule on others in every thing, 
and commonly deliver rigid and tem- 
perate Rules of preserving Health." 

There follow observations on epilepsy, 
palsy, diabetes, quinsy, and the like. In 
commenting on the use of turpentine in the 
relief of the flatus encountered in cases of 
palsies, he takes a literary flight: 

"But it is not so easy to explain, as it 
is true to affirm, that wandering Flatus's 
in the Body are the immediate and near- 
est Cause, both of manifold Pains which 
torture the Miserable, and also of this 
Disease, which is in a Manner anodyne 
and insensible, distinguished rather by a 
Stupidity than Pain. The Theory of 
Flatus's flying through the Body, seems 
as hidden and unknown to us, as the 
Nature of stormy winds, when they war 
sometimes in the Sky with a great Noise 
and thundering, is a hard and difficult 
philosophical Speculation. And, indeed, 
as Winds sometimes raise Storms and 
Tossing of the Waves from the Bottom 
of the Sea up to Heaven, as they some- 
times cause Tremblings and Earthquakes, 
when they are inclosed in the Bowels of 
the Earth; so do Flatus's, being bred 
and shut up in human Bodies, cause 
Gripings, racking Pains, and Convul- 
sions." 

The remaining thirty pages of his book 
are given over to various phases of venereal 
disease. He appreciated their seriousness 
and their devastating influence. 



"The first State of this Distemper, 
which affects only the Pudenda, may be 
slighted, and made a Jest of by our Beaux 
and Rakes, who are wont to look upon it 
as a Matter of small Concern; but when- 
soever that first Degree of Contagion, or 
the following ones, shall at last get into 
their Blood, and spread the Poison 
through the whole Body, they will abun- 
dantly suffer the Punishment due to 
their Follies." 

The modern vice crusader and the propa- 
gandist of the scientific control of venereal 
diseases might well quote Harris. Both 
classes write and teach as if they had dis- 
covered a new thing, as if no one before in 
the history of the world had ever suggested 
the methods now in use. The more one 
reads the earlier writers, the more one 
believes the dictum of Solomon. If not new, 
neither is his suggestion correct, as it only 
involves one part of the problem. Listen 
to Harris: 

"But this we know for a Certainty, 
that there were formerly a great many 
Hospitals built among us for the Recep- 
tion of leprous Persons; and I am much 
mistaken, if we have now so much as one 
single House remaining for the Reception 
of those who are afflicted with the Lep- 
rosy. The same Cause of venereal con- 
tagion has always exercised his Tyranny, 
namely, the casual and promiscuous Use 
of Harlots; and there has never been any 
Age without infamous Strumpets, who 
have made a vile profit by the Prostitu- 
tion of their Bodies; now the Cause being 
given, the Effect also is given, as the 
Effect is taken away when the Cause is 
taken away. For in whatsoever Countries 
or Places, those Prostitutes and common 
Corrupters of Youth are driven far away, 
and the Severity of the Laws restrains all 
whoring, there this Disease is also 
banished together with the impure Har- 
lots. But wheresoever Brothels are per- 



232 



Annals oj Medical History 



mitted, either by the Remissness or Con- 
nivance of the Magistrate; or where- 
soever strumpets can securely acquire 
impure lurking Places; there this Plague, 
with its horrid Train of Evils, and all 
it's Family of Miseries, prevails far and 
wide. And, in my Opinion, this Disease 
is as certainly and naturally produced in 
the impure Wombs of common Pros- 
titutes, who mix their Embraces with 
many different Men, as Lice and Fleas 
are produced from Filth and Unclean- 
Iiness. And because the Corruption of 
the best is always the worst, may not that 
venomous Disease be naturally produced 
by the depraved and incongruous Cor- 
ruption of the prolifick Seed, which is 
designed for such great Uses of Nature?" 

Lack of space prevents quoting some of 
our author's statements about the origins 
of venereal diseases. He calls attention to 
certain Hippocratic descriptions, to various 
current opinions, but in the end he says: 
" I shall leave the Learned at full Liberty to 
dispute." He pays an eloquent tribute to 
the quacks and pretenders, and he tries to 
inculcate the same lesson as that taught 
to-day by the United States Public Health 
Service in their Bulletin, and on the plac- 
ards exposed in certain places, and thus 
familiar, at least, to all who patronize the 
Pullmans. 

"But what Sort of Physicians are 
these? Why, truly, Taylors and Black- 
smiths most commonly, and such like 
Artificers, idle Ale-housekeepers, and 
Cooks, who have already lost their Credit 
in their own Shops. How unhappy there- 
fore and miserable is the Condition of the 
Infected, who suffer double Punishment, 
and are condemned not only to the Tor- 
tures of a most cruel Disease, but also to 
the dangerous Ignorance of an unskillful 
Quack! As if any of the slightest Dis- 
orders stood in need of the Skill of a 
Physician, and the most doubtful of all 



Diseases, that is quite fixt into the Mar- 
row, might safely be committed to the 
most illiterate Fellow!" 

In closing his little book on several griev- 
ous diseases, Harris sums up in a page or so 
his via vitx and it is a page written by a 
sound philosopher or at any rate by a fol- 
lower of sound philosophy, whether one 
accept the Ciceronian view of death or not. 
He counsels honesty, freedom from avarice 
charity, helpfulness and courage. In a sense, 
his philosophy is pragmatic and not unlike 
that of Corin, the shepherd, in "As You 
Like It." 

"I may seem to have described the 
Violence of this Disease with more 
Severity, than some Pretenders to Phy- 
sick, who are wont to slight it, and look 
upon it as nothing; that they may make 
an Ostentation of a certain exquisite Art 
which they have somewhere learned; but, 
in Reality, in order to pick the Purses 
of the Unwary, to oppress their Acquaint- 
ance, and to turn everything unjustly to 
their own Gain and Profit. But it is far 
better for an honest Physician, who has 
been instructed in the Liberal Arts, to 
speak the Truth, rather than to be 
seduced by any Gain, and to prefer the 
common Advantage to his own. Let no 
one repent of having a moderate Fortune, 
provided it be honestly acquired. For a 
little sometimes satisfies our Desires, and 
a great deal seldom satiates the Mind. 
A moderate Plenty of things necessary 
for living well and conveniently is easily 
supplied, and is seldom wanting to good 
Men. But in heaping up Superfluities, 
there is commonly no End of most griev- 
ous Cares, no Weariness of the greatest 
Troubles, no Bound of Rapines; as if 
that dreadful Execration, or Fascination, 
always accompanied the Unjust and 
Avaritious, that they should be poor in 
the Midst of Wealth, and be condemned 
to spend a very unquiet and penurious 



Walter Harris, a Seventeenth-Century Pediatrist 



233 



Life in the Midst of Abundance. Our 
short Lives slide away with a precipitate 
Course. And there is no need of a great 
Pomp of Provision, to make the Journey- 
agreeable, nor is so great a Plenty neces- 
sary to be laid up for so short a Way. I 
think it well done by them, who pass their 
lives in doing well. Nor should wise Men 
lament the Death of the Body, which is 
followed by the Immortality of the Soul. 
For then at last it is manifest that we 
live, when we are departed out of this 
Life. How excellently did the Philosopher 
speak to this Purpose, when his Breast 
was swelling with Hope, full of Consola- 
tion, and his Mind greatly aspiring to 
future Joys, when he was approaching 
to old Age, and nobody praising it? If 
I err in this, says he, that I believe the 
Souls of Men to be immortal, I willingly 
err: Nor will I suffer myself to be per- 
suaded out of this Error as long as I live." 

The little book on diseases of children was 
the popular treatise from his time until it 
was supplanted in 1784 by the work of 
Michael Underwood. The first edition was 
printed at Amsterdam in 1689, while Harris 
was in Holland with King William. It was 
reprinted in 1705, 1720, 1736, 1741, and 
1745; translated into German in 1691, 
French, 1738, and twice into English, 1742 
(Norman Moore). The English translation 
was by John Martyn, F. R. S., professor of 
botany at Cambridge, and the title-page 
states that it was "written originally in 
Latin by the late Walter Harris, M.D., 
Fellow of the College of Physicians at Lon- 
don and Professor of Chirurgery at the same 
College." Martyn states that a previous 
translation into English "was in a most 
uncouth style." This having been out of 
print, the 1742 translation was published 
with a translation of the author's observa- 
tions on several grievous diseases. Martyn 
states^that "he wished that the learned 
author had used rather less prolixity in his 



writings and been more sparing in his 
"Digressions." He wisely also omitted "the 
long enumeration of the Titles of the Illus- 
trious Parents of the Doctor's Infant 
Patients." 

Harris was a conceited man, of that there 
can be no doubt; and had Fate been kind 
enough to spare us his portrait there is no 
doubt he would have shown it in his face. 
Still, he disclaims any credit for his work in 
his preface, where the modern psycho- 
analyst would shrewdly discern that in 
attempting to keep away from a subject he 
overstepped it in another direction. 

"For let a Piece be ever so well written, 
yet we ought by no Means to suffer our- 
selves to be proud of it. For the highest 
Wisdom and Knowledge of Men seems to 
be that which places our common Folly 
and Ignorance before our Eyes. And the 
more any one exceeds others in being 
conscious to himself of this common 
Ignorance of Things, and Deficiency of 
right Reason, the more I think him 
superior to others, and to obtain the first 
Place in Knowledge." 

Physicians are not able to do much for 
suffering humanity. Among the causes of 
their inefficiency Harris gives the following: 

"Because of the usual Delay of sick 
Persons, and their foolish Procrastination, 
before they will consent to send for a 
skillful Physician; because of the great 
Abundance of Medicines, both simple 
and compound, and the avoiding of too 
much of a candid simplicity of pre- 
scribing, instead of which has succeeded 
a fine and glorious Method, but more 
fallacious in the Variation of Remedies, 
for fear the Learned should seem to 
others to be not sufficiently instructed in 
the Knowledge of the abundant Profusion 
of Medicines; and also because of the 
necessary Variation of the Method of 
Cure in different Countries and Climates, 
which is also to be changed in the same 



234 



Annals of Medical History 



Country, according to the various Sea- 
sons of the Year; and because of the 
successive Change of Helps in almost 
every Age, according to the Modes of 
Practice that prevail; and, lastly, because 
of the different Opinions and dissimilar 
Doctrines of learned Men, who eternally 
differ from each other." 

The difficulties and discouragements of 
pediatric practice made a deep impression 
on Harris and he is at pains to let it be 
known, just as he also points out what he 
regards as an infant and the diagnostic 
methods to be pursued in dealing with such 
uncommunicative creatures. 

"I know very well in how unbeaten and 
almost unknown a Path I am treading; 
for sick Children, and especially Infants, 
give no other Light into the Knowledge 
of their Diseases, than what we are able 
to discover from their uneasy Cries, and 
the uncertain Tokens of their Crossness; 
for which Reason, several Physicians of 
the first Rank have openly declared to 
me, that they go very unwillingly to 
take care of the Diseases of Children, 
especially of such as are newly born, as 
if they were to unravel some strange 
Mystery, or cure some incurable Dis- 
temper. 

"There can be no Doubt but that a 
perfect Cure of the Diseases of Children 
is as much to be desired by all, as any 
Thing else whatsoever in the whole Art 
of Physick. Nor is it of consequence only 
to the noble, the powerful, and the 
wealthy, who are desirous of having 
Heirs, and preserving them, but to all 
Parents of any Rank whatsoever; for 
Nature has instilled into all Men an 
almost invincible Love and Care of their 
own Offspring. Wherefore I shall think 
myself happy, if I can strike out a few 
Hints, which others of greater Abilities 
may improve, and bring to Perfection." 

"By an Infant I mean not only with 



Galen, one of a Month, two Months, or 
at most three Months old, but in a more 
extended Sense, as it is commonly under- 
stood, a little Child something older, as 
far as to the fourth Year. Under the Name 
of a Child I comprehend all from that 
Age to the fourteenth Year. And the 
younger the Patient is, the more easy 
will be the Cure of any severe Disease, as 
I have found from the best Reasoning, 
confirmed by manifold Experience. For 
any Impression, either good or ill, is 
sooner made on the moist than on the 
dry, on the soft than on the hard, tho' in 
the dry and hard, when it is once made, 
it continues longer. Infants fall into 
Diseases the most easily, and unless they 
are unskillfully or too late taken care 
of, are most easily restored to Health. 

"The Diagnostick of the Disorders of 
Children is not to be formed from their 
own Account, or from the Consideration 
of their Pulse, or from a curious Examina- 
tion of their Urine, so much as from the 
Answers of their Nurses, and of those 
who are about them. For the Women are 
able to tell whether they are sick and 
vomit, and how long they have done so; 
whether they throw up Milk or Food 
curdled; whether frequent Cries, Watch- 
ings, and Uneasiness, discover them to be 
griped; whether they have sour Eructa- 
tions or Hickups; whether they have any 
Cough; whether their Stools are larger, 
smaller, or more frequent than usual; 
what Colour they are of, whether white, 
green, or of the full yellow Colour of the 
Bile. They can tell whether they have 
little Ulcers, called the Thrush, spreading 
in their Mouths and interrupting their 
feeding. If you ask them, they can answer 
whether they have Convulsions, greater 
or less, of a longer or shorter Continuance, 
and whether they have frequent or seldom 
Returns; they can see whether any Part 
of the Gums grows white or swells, and 
therefore, whether it is their being about 



Walter Harris, a Seventeenth-Century Pediatrist 



235 



their Teeth that disorders them; lastly, 
whether there is any Thing else of Con- 
sequence, whether they have a Swelling 
of the Abdomen, or any other Part, 
whether they have any Eruptions or 
Pustules, and whether a yellow or red 
Colour appears externally. As for most 
other Enquiries, they seem to me to 
belong rather to subtile Speculation than 
Practice." 

Hereditary influence in the production of 
disease in children was correctly estimated 
by Harris, who states that "the Knowledge 
of the procatartic Cause must not be totally 
omitted." He dwells on this and adds an 
interesting little paragraph on eugenics: 

"There is no one who will deny, that 
there are hereditary Diseases, proceeding 
either from one or other of the Parents; 
or question but that the Gout, Epilepsy, 
Stone, Consumption, etc. sometimes flow 
from the Parents to the Children. Whole 
Families proceeding from the same Stock, 
often end their Lives by the same Kind 
of Disease. For the prolific Seed often so 
rivets the morbid Disposition into the 
Foetus, that it can never afterwards be 
removed by any Art or Industry what- 
soever. But let those who prefer a strong, 
vigorous, and healthy Offspring before 
Money, take care to avoid epileptic, 
scrophulous, and leprous Mothers." 

With the passing of the mint julep of the 
South, the only julep which the mind con- 
jures up at the mention of the word, it is 
not uninteresting to read a paragraph on 
the juleps of Harris' day and of the pearl 
julep and others later on. 

"The modern Juleps by the Way, 
derived from Distillation, were wholly 
unknown to the ancient Physicians. 
Water, Wine, Ptisan, or a Decoction of 
decorticated Barley; Melicraton, or an 
extemporaneous Mead; OivoneXt, or 



Vinum passulatum, a Sort of Raison 
Wine, being expressed from dried Grapes ; 
Sapa, or boiled Wine; Posca, Oxycratum, 
or Vinegar mixt with Water, were almost 
all the Juleps that were used by our 
Ancestors, in the Practice of Physick. 
But whether these Juleps of the Ancients, 
on Account of their Simplicity, Smallness 
of Expence, and exnrop^ia or those in 
modern Practice, because they are more 
agreeable to the Palates of the Nice, and 
Desires of the Rich, ought to be preferred, 
I shall leave to the Determination of the 
sagacious, skilful, and honest Physician." 

Harris knew full well the importance of 
correct diet in early life and cautions espe- 
cially against errors in this regard. He con- 
demned the use of flesh in infancy and stated 
that the results of this regimen are "almost 
inseparable from the overfeeding of tender 
Infants." Also, "Crude and undigested 
ailment necessarily produces a Putrefaction 
of Humours: from which Putrefaction not 
only Worms are generated, but various and 
grievous symptoms, by which the poor 
Wretches are wasted, very often depended 
upon it." 

In these dry and parlous days (July, 
19 1 9), Harris' views on wine may not be 
amiss. Correctly he is against its use in 
early life, as was Galen of old, and there are 
those who agree with his decision regarding 
later life. 

"The nearer any one approaches to old 
Age, the more does Wine moderately 
taken usually agree with him. For the 
languid Heat of old Men evidently stands 
in need of spirituous Helps, which are 
plentifully supplied by Wine, both for 
the Preservation and Increase of their 
natural Heat. Wherefore the Nature of 
Infants, being the most remote from that 
of old Age, is greatly injured by Wine, for 
their Nerves being exceedingly weak are 
easily destroyed thereby, and their tender 
Bodies are gradually dissolved, or else 



236 



Annals of Medical History- 



rush hastily into feverish Flames, by the 
subtile Heat of Wine." 

How delighted, however, would the West- 
erville set and their followers be over the 
following paragraph! It reminds one some- 
what of the descriptions in school physiol- 
ogies. 

"Wine of all Sorts taken too freely, as 
well as all Sorts of Spirituous Liquors, 
destroys the natural Ferment of all 
Stomachs, especially of those of Children : 
they impair the Appetite, burn up the 
Coats of the Stomach, and wrinkle them 
like Parchment that is scorched by the 
Fire; but they most of all injure the 
nervous Coat, which in this Case is of 
the greatest Moment, and by Means of 
this Coat, weaken all the Nerves of the 
Body, and most certainly drive the 
animal Spirits into all Sorts of Confusion. 
What does the least Injury to this tender 
Age is White Wine, which was accounted 
cold by the Ancients, but is not abso- 
lutely cold, but only comparatively with 
Regard to other Wines, whether red, 
tawney, or yellow. But Galen, as was 
said before, forbids Children to taste 
any Wine at all." 

In another place, after reviewing the 
modern writings on acidosis, the present 
writer was tempted to paraphrase Pilate's 
query: "And what is acidosis?" We present- 
day moderns, as many now agree, are too 
prone to the vulgar error that our own 
opinions are new and original. As a matter of 
fact, for the most part, they are neither. Ideas 
do not die. They fall asleep, perhaps for 
centuries, and then come to life often simul- 
taneously in several different places as a 
"Schwebender Gedanke." Witness Garri- 
son's account of the caduceus used as a 
medical symbol by the Babylonians and dis- 
appearing to bob up in England and Swit- 
zerland in the sixteenth century. 

To read the moderns is to believe that 



acidosis and alkalies as a cure date from 
yesterday. If ever any one lived who 
thoroughly, believed in the noxiousness of 
acid and in the effectiveness of testaceous 
remedies it was Harris. Of the latter we shall 
speak further on. Of acidosis he says: 

"All the Causes of the Diseases of 
Infants, which have been already men- 
tioned, and all that may be derived from 
them, center in one next and immediate 
Cause, namely, an Acid prevailing uni- 
versally." 

He describes the symptoms as follows: 

"That unequal Condition of the Chyle 
or Nutriment, constantly owing itself to 
a predominating Acidity, chiefly pro- 
duces a Sickness, Vomiting, and sour 
Eructations. If the Affair is farther pro- 
longed, they grow paler and paler by 
Degrees, and the discoloured Counte- 
nance discovers a Mixture of yellow or 
green. Then the Stomach swells with 
Inflations, and flatulent Eruptions are 
thrown upwards. In the mean Time a red 
Pimple or two, a sure Sign of an abound- 
ing Acid, appears on the Skin, in some 
upper Part of the Body, sometimes on 
each Cheek, sometimes on the Chin, 
sometimes on the Forehead, or Neck, or 
sometimes lower; and the Infant daily 
grows worse. He wheezes also, and draws 
his Breath so hard as to disturb the Ears 
of those who stand by; [acidosis and 
asthma] which Symptom is always found 
to affect him, especially if he is fat, 
whensoever the Disease is of the acute 
Kind. Besides, he is often affected with a 
light, dry, and sometimes suffocating 
Cough; a dry one, because the Acrimony 
of the Humours continually vellicates 
the Branches of the aspera arteria, which 
are very sensible; a suffocating one, be- 
cause the Bronchia of the Lungs are 
grievously loaded with serous Humours 
distilling upon them, and not finding an 



Walter Harris, a Seventeenth-Century Pediatrist 



237 



Outlet. Moreover, because they have the 
greatest Weakness of their nervous Sys- 
tem, and have the highest .Degree of 
Softness and Tenderness in their Con- 
stitution, therefore they are ready to sink 
under the violent Agitation of the Breast, 
being in a Manner suffocated, and black 
in the Face. But if the Coagulations 
already mentioned descend presently, as 
they often do, from the Stomach into the 
Intestines, they sometimes produce Grip- 
ings, sometimes greenish Stools, and 
sometimes violent Loosenesses. But whilst 
the Tragedy is acted in the lower Belly, 
either the great Pain of the Gripes lights 
up an acute Fever, which, if not rightly 
managed, usually deprives the Infants of 
their Lives; or else the Pain being a little 
more moderate, and giving Way perhaps 
to some unskillful Cure, often ends in a 
hard Tumour of the Abdomen, [Tabes 
mesenterica] which in some readily serves 
to promote the Rickets or King's Evil." 

He paints a gruesome picture of maras- 
mus, convulsions and death, and includes 
in the list of troubles owing their origin to 
acid, thrush, ulcers in the mouth, green 
stools, the watery gripes. [Cf. Howland's and 
Marriott's work on the acidosis accompany- 
ing infantile diarrheas and their suggestion 
of the use of sodium bicarbonate.] 

Harris was not modest about his hypoth- 
esis, for he immediately starts out to dis- 
claim any honor, a sure sign that he thought 
it his due. 

"Here I shall note by the by, that I do 
not by any Means seek after the Honour, 
if there is any to it, of finding out a new 
Hypothesis, nor if I have found out, or in 
any Manner established an Hypothesis, 
do I think it my Business, to force all 
Sorts of Arguments, even in spite of 
Nature, as the Custom is, to strengthen 
and support such an Hypothesis." 

He also foresaw a discussion with which 
he did not propose to bother himself. 



"I know well enough, that all the 
subtile Animadverters, will find fault 
with this Notion that I have started, of 
an Acid prevailing in all the more 
remarkable Disorders of Children." 

He goes on to quote at length from Hip- 
pocrates and states: 

"From these, and many other Things 
of the same Sort, which are laid down at 
large in the above-mentioned Book, it is 
plain, that our Divine Old Man, who 
excels all others in Medical Knowledge, 
determined as a certainty, that those 
secondary Qualities, namely, Acidity, 
Bitterness, Saltness, and such Like, being 
joined with the Symptoms of Heat or 
Cold, are to be considered chiefly as 
Principal and efficient Causes of Dis- 
eases. And therefore I shall make no 
Doubt to add that it necessarily follows, 
that the Cure itself is to be directed in the 
first Place, not so much to the extinguish- 
ing of Heat by Cold, as to the blunting of 
an Acid, the Iatering of a Bitter, the 
attempering of a Salt, the cutting of 
thick Humours, and the rendering of 
such as are thin and too fluid more com- 
pact, the asswaging such as are rough, 
and, lastly, to the opening of the obstruct- 
ed Ducts of the Body, and freeing them 
from their Infarctions. 

"But before I attempt the Cure itself, 
it may seem proper, according to usual 
Custom, to premise some Prognosticks." 

His statement about the seasonal appear- 
ance of diarrhea is equally true to-day; we 
have done little to make any change in it 
necessary. 

"From the Middle of July to about the 
Middle of September, the Epidemical 
Gripes of Children are so rife every Year, 
that more of them usually die in one 
Month, than in three or four at any other 
Time: For the Heat of that Season com- 



238 



Annals of Medical History 



monly weakens them at least, if it does 
not entirely exhaust their Strength." 

Harris gives Sylvius de Ie Boe credit for 
having written about acids as a cause of 
disease in infants, but he scorns him for his 
use of narcotics and applies to him the 
name of the "Opiate Doctor." 

As to cure, Harris wisely insisted on sim- 
plicity, which we of to-day applaud; yet 
some of his prescriptions look formidable 
enough. On this point he says : 

"As their Ailment is the most simple, 
so the Medicines that are commonly to 
be given them, ought to be simple, but 
little receding from their natural State, 
and for the most Part void of too la- 
borious an Artifice." 

Of the cure another quotation may be 
used: 

"But if we may be allowed fairly to 
speak the Truth, and so not desire to 
lose all our Pains and Troubel, those 
Things which tend directly to subdue an 
Acid, are the only Things that promote 
the Cure; but whatsoever do not tend 
that Way, at least disturb the tender 
Bodies of Infants more or less." 

His idea was first to neutralize the acid 
and get rid of it by purgation. The first he 
expounds learnedly and at length, as the 
preparation of the acid; finally, after pay- 
ing his respects to Hippocrates and Syden- 
ham, and skillfully belittling the efforts of 
others, he comes to the meat of his thera- 
peutics : 

"The Preparation therefore of which 
we are now speaking, is not by any Means 
to be obtained by Sudorificks properly so 
called, that is, by Medicines that heat 
the Body, which are not in any Degree of 
Advantage to tender Infants or Children, 
but are found many Ways to hurt them. 
Whereas things that are quite temperate 
will securely absorb the prevailing 



Acidity, gradually assuage the Ebullition, 
and become powerful and safe Anodynes. 
Such are Crab's Eyes and Crab s Claws, 
Oister Shells, Egg Shells, Chalk, Coral, 
Coralline, Pearls Mother of Pearl, 
oriental and occidental Bezoar, burnt 
Hart's-Horn, burnt Ivory, Bone of a 
Stag's Heart (the terra sigillate of the 
ancients), shavings of Hart's-Horn, Uni- 
corn, Armenian Bole, sealed Earth, Blood 
Stone, &c. Of Compounds, Gascoign's 
Powder, Goa Stone, and Species of the 
Confection of Jacinth, will obtain the 
first Place." 

On the choice of these "testaceous pow- 
ders or absorbents of acid," he descants at 
some length, declaring that the cheaper 
are as good as the more expensive, albeit 
"For such Things as cost a great deal 
of Money, and are brought a great Way, 
are always the best in the Opinion of the 
Ladies." 

Of the cheaper varieties he has certain 
preferences : 

"But yet if, among many testaceous 
Bodies of almost the same Nature, I 
would prefer one before the rest, I should 
commend common Oister-Shells, such as 
are found on the Sea-Shoar, and have 
endured a long Insolation, being ripened 
into Use by the benign Rays and vivific 
Heat of the Sun, and thereby far better 
prepared than by a Chymical Fire, and 
changed into a bluish or yellowish 
Colour." 

Of other alkalies, he has not much to say, 
but dismisses them with the following 
statement: 

"I have designedly made no mention of 
Volatile Salts, whether they be oily or 
spirituous; none of Mineral, Lunar or 
Solar Bezoar; none of Spirit of Sal Am- 
moniac, none of that of Hart's Horn; of 
which Spirits the use is however not to be 



Walter Harris, a Seventeenth-Century Pediatrist 



239 



entirely exploded with Regard to the 
most tender: because they excel in a 
Power of Absorbing Acids; but I would 
observe, that they are to be used with the 
greatest Caution, because of the no small 
Heat that accompanies them. And there- 
fore we have to Reason to extol Iixivial 
Salts, or the hotter Cordial Waters, such 
as compound Peiony Water, Plague 
Water, Aqua Coelestis, Aqua Mirabilis, 
strong Cinnamon Water, and such like, 
unless they are given in a very small 
Quantity, and so diluted with other more 
temperate Waters, so as to make their 
heating Power almost insensible to the 
Taste." 

After going over his ideas on the subject 
of acid, he comes to the practical part 
designed to help the "young beginner." 
Some idea of his practice may be had from 
the following suggestions: 

"But to pursue my Design, for an 
Infant of a Year old in a Fever, or, as it 
commonly happens, tormented with the 
Gripes, we may prescribe as follows: 

"Of the simple compound Powder of 
Crab's Claws, of each one Dram, divide 
them into six equal Parts. 

"Or, 

"Oriental Bezoar, Pearls prepared, and 
Crab's Eyes, of each half a Dram, Species 
for the Confection of Jacinth one Scruple, 
reduce them to Powder, and divide them 
in like Manner. 

"Or, 

"Oister Shells, prepared without Fire 
three Drams, Native Sulphur one Dram, 
Crystal Mineral two Scruples, reduce 
them to Powder, and divide them into 
twelve Papers. 

"Or, 

"Simple Powder of Crab's Claws one 
Dram, Crab's Eyes prepared two 
Scruples, Cochineal six Grains, reduce 
them to a very fine Powder, and divide 
them into six Papers. 



"The Infant may take one of these 
Doses immediately, and repeat it, if 
necessary, two Hours afterwards, and 
then once in four Hours, except when 
asleep, for the first two Days. The Powder 
may be taken in a Spoonful of the fol- 
lowing Julap, drinking another Spoonful 
after it." 

His suggestions as to purges for infants 
are certainly sound, for after mentioning 
several, both simple and compound, he 
sums up with a strong vote in favor of 
rhubarb : 

"Of all the purging Medicines, I know 
none more suitable to the puerile Age, 
or more innocent in itself, than Rhubarb, 
which is so well known, and so much in 
Use. It brings down the Matter of the 
Fevers of Infants both gently and safely: 
it mildly purges the Stomach, nay and 
the whole Body, of vicious Humours, 
and strengthens it also; and therefore is 
the fittest to be given to Infants, Chil- 
dren, women with Child, old Men, and 
such as are already weak with any Dis- 
ease. Rhubarb seems better to deserve the 
Name of Hiera or sacred, than Aloe, 
which was so wonderfully extolled by the 
Ancients, and has not been undeservedly 
celebrated by the Moderns, and holds the 
first Place, and is the Basis of almost all 
Officinal Pills. Indeed, on Account of its 
extraordinary Bitterness, it often de- 
serves no small praise in grown Persons; 
but because of it's Acrimony, corroding, 
and the Heat that it gives the Body, it is 
not very safe for Children." 

The last score of pages digress somewhat 
from the diseases of children to a sort of 
rambling philosophy on the nature of things 
in general. He pays his respects to the 
"Chymists" and their "Chymicals" which 
he is none too ready to use; he gets after the 
"bellows blowers," "quacking operators," 
and "old women," and gives an estimate of 



240 



Annals of Medical History 



the worth of the wisdom of the ancients. 
He closes his treatise in a pious prayer, 
which shall be our last quotation : 

"May the great and good God, from 
whom, as from an ever inexhaustible 
Fountain, all good and happy Things 
continually come down, and on whose 
Favour and Blessing the happy Success 
of the Art of Physick chiefly depends, 
vouchsafe, out of his immense Goodness, 
to bless what I have faithfully written 
with a sincere Mind, that it may be for 
the Publick Benefit, which ought always 
to be preferred before private Advan- 
tage." 

Harris was not a great physician, not a 
master mind, not an original thinker, but 
he wrote a good book that held its place an 



hundred years; he was a shrewd and honest 
practitioner; a keen observer, particularly 
of the action of drugs, which led him to 
teach simplicity, caution and common sense. 
As will be seen from the portions of his 
work cited, he was au fond one of the 
soundest of the earlier writers on pediatrics. 
Was he bombastic? So was his teacher 
Sydenham, and the age in which he lived 
was tinctured with bombast. Was he garru- 
lous? So was his very human contemporary 
Pepys; so, too, at times, were Hippocrates 
and Galen. Was he conceited? So have 
been many men who were successful prac- 
titioners but not very profound students of 
life. Taken all in all, he was a delightful 
old fellow and one with whom any present- 
day pediatrist might spend an hour with 
pleasure and with profit. 



JOSEPH RODMAN DRAKE, M.D. 



This year marks the centenary of the 
death of a young American physician whose 
fame as a poet far overshadows any re- 
putation he might have acquired in his 
brief life as a physician. 

Joseph Rodman Drake was born in New 
York on August 7, 1795 and died in that 
city on September 21, 1820. He was buried 
in a small cemetery in the Bronx, which 
some years ago was acquired by the city. 
Drake began writing poetry when but four- 
teen years old. He studied medicine under 
Drs. Bruce and Romagne, and received the 
degree of M.D. from Columbia College. 



There is no information extant as to whether 
he ever seriously followed his profession. 
In 1 816 he married a Miss Eckford, the 
daughter of a very wealthy shipbuilder, 
and it is probable that he then felt at 
liberty to devote himself entirely to literary 
work. It was in the summer of 181 6 that he 
wrote the poem by which he is chiefly 
remembered, "The Culprit Fay." He and 
Fitz-Greene Halleck, the poet, were the 
closest friends and wrote much in colla- 
boration. Halleck was at his bedside when 
he passed away and wrote of him after- 
wards the familiar lines, 



Green be the turf above thee, 
Friend of my better days; 
None knew thee but to love thee, 
None named thee but to praise. 



NEW OBSERVATIONS IN PALEOPATHOLOGY 
By ROY L. MOODIE, Ph.D. 

Department of Anatomy, University of Illinois 
CHICAGO, ILL. 



RECENTLY the writer was able 1 
to spend some time studying 
evidences of paleopathology in 
^the principal museums of the 
Eastern cities, which resulted in a number 
of new observations on the nature of many 
ancient diseases. It is thought worth while 
to present here a discussion of the new facts 
and those observations which correct pre- 
vious false conclusions. A full discussion, 
with appropriate illustrations, will be pre- 
sented in a treatise on paleopathology, now 
in course of preparation, showing the rela- 
tion of these new facts to previous observa- 
tions, and drawing further conclusions. 

Spondylitis Deformans in the Dinosaurs. — 
Coalesced vertebrae have been frequently 
seen, described and figured, in the skeletons 
of the huge land reptiles of the Mesozoic, 
and Osborn especially has referred to them 
as being the resting point of the tail, which 
means, I assume, that these gigantic animals 
stood erect and supported themselves with 
the tail, like the kangaroos. The difficulty 
with this interpretation is that the coalesced 
vertebrae often occur elsewhere in the skele- 
ton than at the proper point in the tail. Coa- 
lesced cervicals are known in Camara- 
saurus, Diplodocus and Tyrannosaurus, and 
doubtless close scrutiny of the known 
material would reveal the lesions elsewhere 
in the body. The condition was extremely 
puzzling until a series of five caudals of 
Diplodocus were studied in the American 
Museum of Natural History. A fortunate 
post-fossilization fracture revealed the un- 
affected articular surfaces of the vertebrae 
in two places and showed the ring-like 
growth of the lesion, similar in all respects 
to the modern advanced cases of Spon- 

1 Aided by a grant from the Committee on Scien- 
tific Research of the American Medical Association. 



dylitis deformans, seen so commonly in 
mammals and in man. Ruffer has reported 
a case of spondylitis from a Miocene croco- 
dile of Egypt, so the disease is not unknown 
among reptiles. Its age, however, is greatly 
extended by the recent observations, and 
it is probable that further study will carry 
the antiquity of this peculiar pathological 
condition far back into geological time. 

Spondylitis Deformans in Eocene Mam- 
mals. — Definite evidences of similar pa- 
thology were observed in two small mammals 
from the Eocene, one being in the tail, and 
the other in the anterior dorsal region. 
The lesions are so similar to those of human 
pathology that additional descriptions are 
unnecessary. No evidences of the incipient 
lipping were definitely observed, though it 
was suggested in a number of cases. The 
lesions may not have followed the same 
method of formation in ancient times which 
they follow now. 

An Ankylosed Elbow-Joint in an Eocene 
Mammal. — A small, primitive, five-toed un- 
gulate from the Eocene, known as Ectoconus, 
had in life suffered a fracture of the left- 
humerus immediately above the condyles, 
resulting in the coalescence of the articular 
end of the humerus in the olecranal fossa. 
A pseudarthrosis was formed between the 
fractured end of the humerus 2 and the 
radius particularly, though some new joint 
surfaces occurred also on the ulna. The 
joint surfaces were dense and eburnated, 
recalling in their ivory-like consistency, the 
eburnated surfaces in joint lesions of the 
so-called rheumatoid arthritis. The fracture 
had evidently been extremely septic, for 
the whole lateral surface of the ulna is 
pitted with necrotic sinuses and roughened 

2 1 have seen a similar fracture in the femur of 
a bison from the plains of Kansas. 



241 



242 



Annals oj Medical History 



with carious bone. In fossilization the bones 
were all crushed flat, so a detailed study of 
the joint lesion would not reveal a great 
deal more than is shown in an external 
examination. This is the oldest known 
ankylosed elbow, with an antiquity of 
many millions of years. 

A Subperiosteal Abscess. — The limb bones 
of the huge dinosaurs of the Mesozoic were 
seldom fractured, because of their great 
size and strength. A single limb bone of 
one of the largest animals has a length of 
six feet and a weight, as fossilized, of about 
700 pounds. But one of the horned dino- 
saurs of the Edmonton Cretaceous, dis- 
covered by Barnum Brown, has suffered 
an oblique fracture of the humerus which 
healed in a very bad way, resulting, as Mr. 
Brown said, "In the sickest fossil bone I 
have ever seen." On the anterior surface 
of the bone the periosteum had doubtless 
been greatly elevated by an ingrowth of 
callus, which later ossified into a bridge of 
bone connecting the lower articular surface 
with the enormous deltoid crest, and cov- 
ering an enormous abscess, capable of hold- 
ing several liters of pus. 

Prehistoric Trephining. — The antiquity of 
this interesting surgical process is clearly 
established, and there are hundreds of 
trephined skulls in various museums which 
yield much information to the student of 
paleopathology. An interesting series at the 
United States National Museum reveals a 
number of interesting points with remark- 
able clearness. The skulls are from Peru of 
pre-Columbian age, a very large percentage 
of which show clearly that trephining was 
performed by the primitive surgeon to 
relieve fractures, either depressed or linear. 
The injuries to which the heads of the 
ancient Peruvian Indians were subject were 
made by: (a) Blows from the star-shaped 
club so commonly used by these people; 
(b) sling shot injuries, which would pro- 
duce small depressed fractures often pene- 
trating the two tables of the skull; (the use 



of sling shots is very common in Peru and 
men, women and children are adept in the 
use of this instrument; the process of 
trephining, if completed, would often re- 
move all traces of this type of fracture if 
made with a small rounded pebble) (c) 
blows of other kinds or falls producing 
fractures; and (d) arrow point injuries. 
Trephining for any of these injuries falls 
into four categories, given in the order of 
frequency; (1) Sawing; (2) cutting; (3) 
scrapping; and (4) boring. 

In practice of scraping the outer table 
was completely denuded over a wide 
area, often covering six square inches of 
bone, and the trephine opening made in 
one margin of the scraped area. Sawing and 
cutting were done by bronze or obsidian 
instruments. Doctor Hrdlicka showed me 
some of the obsidian knives which doubtless 
had been used for this purpose. The plaque 
of bone removed at the operation was sel- 
dom replaced and usually the scalp 
was drawn over the opening and closed 
with healing herbs and gums, the use of 
which were clearly known to the Peruvians 
of ancient times. Occasionally fragments of 
gourd was inserted into the opening and 
fitted to it. Metal was also used. There are 
some evidences of successful bone grafts in 
the skull, but their relation to trephining has 
not been clearly established. The geographi- 
cal distribution of the operation was curi- 
ously irregular, but it spread northward 
from Central Peru as far as the Rio Grande. 
In Macchu Picchu no evidences of trephin- 
ing were found, but from Paucarcancha, 
Patallacta, and Torontoy MacCurdy 3 has 
described great numbers of trephined skulls, 
many of them trephined more thanjonce. 
One skull in Yale University had^been 
operated upon at five different times; twice 
in the left frontal, the openings almost 
contiguous, once in the vertex, once in the 
right parietal and once in the right occipital. 

3 Art and Archeology, December, 19 18, "Sur- 
gery Among the Ancient Peruvians." 



New Observations in Paleopathology 



243 



The margins of these openings show clear 
evidences of healing. Ruffer suggested that 
trephining was always performed near the 
vertex because this was the most con- 
venient place, but clearly the Peruvian 
skulls do not show this. The operator 
attacked the site of the injury, irrespective 
of location. Trephining was done on men, 
women and children, on deformed and nor- 
mal skulls. There is, however, no evidence to 
show that the operation was ever performed 
for the removal of diseased bone, and patches 
of necrotic bony tissue are fairly common 
in these skulls. It seems probable that the 
prehistoric surgeon practiced his operation 
on dead material and reached his conclusions 
from experimentation and logical deduction. 

Osteoporosis. — This pathological result is 
often evident in ancient human skulls, and 
is many times bilaterally symmetrical. 
Patches of bone in the roof of the orbits, 
on the parietals, frontals and elsewhere, 
bilaterally symmetrical, show the dissolu- 
tion of the bone in the curious rounded 
openings, largest at the center and becom- 
ing smaller toward the periphery. Hrdlicka 
has described and figured the best known 
example of this in an adult male skull from 
Peru. Often, however, porosities occur 
which are not of this type. They often 
result in penetrating sinuses through the 
entire skull wall. Eaton has interpreted one 
example of this type as due to syphilis. It 
is probable, however, that there is some 
relation between these necroses and a 
curious type of osseous, reticular tumor 
occuring on the skull, a splendid example of 
which is in Yale University. It is hoped that 
Doctor MacCurdy will soon describe this 
interesting tumor. 

Osteomata. — Small ivory-like, smooth, 
osteomata are often seen on prehistoric 
skulls very similar, in general appearance, 
to the button-like growths of eburnated 
bone seen on modern skulls. Their etiology 
is doubtless similar. They occur most often 
on the frontal, and are always single. 



Paleopathology of the Pre-Columbian North 
American Indians. — The Indians of North 
America were relatively free from disease 
in general, and most of our modern virulent 
diseases were apparently absent. The great- 
est difficulty in the study of the ancient 
diseases of this continent is encountered 
in the inability to determine the age of the 
bones exhibiting the pathology. Intrusive 
burials into ancient mounds and the late 
formation of the burial mounds, continued 
for centuries after the white men reached 
this continent, are responsible for the diffi- 
culty. On this account it was especially in- 
teresting to learn from Doctor Hrdlicka that 
there is in San Diego a splendid collection of 
pre-Columbian North American Indian skel- 
etons from a single locality, exhibiting many 
forms of pathology. All of this is ancient, 
and a study of this collection would result 
in our having a fundamental idea of the 
types of pathology present among our 
predecessors, the red men. An interesting 
ancient cemetery at Madisonville, Ohio, 
has already been explored and has yielded 
many types of pathology. 

American Cave Bears. — Virchow, Mayer, 
Esper, Schmerling and the other founders 
of paleopathology did their initial observa- 
tions on the diseased bones of cave bears 
of Europe. Esper, in 1776, initiated the 
subject by describing what he took to be an 
osteosarcoma on the femur of a cave bear. 
It is extremely interesting then to observe 
in the United States National Museum, in 
a collection of mammalian fossils from the 
Cumberland Cave deposit of Maryland, 
diseased bones of a large American cave 
bear. A right femur shows on the lower 
posterior surface a wide area of carious 
roughening, with low, blunt osteophytes. 
A skull of an ancient pig shows similar 
carious patches on the left mastoid. This 
collection, soon to be described by Doctor 
J. W. Gidley, will add much to our knowl- 
edge of disease in the American Pleistocene. 

Pathology of the Clam. — In the Miocene 



244 



Annals of Medical History 



of the Eastern States there occurs a large 
species of clam, known to paleontologists as 
Venus tridacnoides. The shell is immensely 
thickened and very heavy. Doctor Gilbert 
Van Ingen of Princeton, to whom I am 
indebted for calling my attention to this 
species, regards the form as a pathological 
race of Venus rileyi, a normal clam occurring 
in the same beds. Thickening in the tests 
of ancient invertebrates, simulating osteo- 
hypertrophy in vertebrates, is fairly com- 
mon. A careful study of this pathological 
clam would result in interesting data. 

Definition oj the Term Paleopathology. — 
The term, so far as I can learn, was first 
placed in the literature by Doctor Ruffer 
in 1914, and his definition has been given 
in a previous paper. 4 The subject, how- 
ever, had received earlier attention in this 
country in the paleontological labora- 
tory of the state museum of New York, 
where Doctor John M. Clarke has done so 
much on the nature of Paleozoic parasitism, 
and the intimate association of primitive 
animals, which was the initial step of parasi- 
tism, and which is essentially pathologic. 
The idea, however, while original with 
Ruffer, had doubtless occurred to workers 
in other fields, and while Ruffer properly is 
entitled to the credit of first publishing a 
definition of the term, the other workers 
should receive due recognition. 

Caries. — I have stated elsewhere that 
caries of the teeth is fairly common among 
fossil vertebrates, yet a careful investiga- 
tion into the matter reveals the interesting 
fact that it seems to be the rarest form of 
pathology in ancient times. It is true that 
D0II0 in the mosasaurs, Renault in fishes 
and Leidy in the mastodon, have described 
this form of pathology; yet it seems not to 
be common. Experienced collectors of fossil 
mammals have never seen a carious tooth. 
In one of my papers on the basis of the 
appearance of the photograph I figured 

4 Annals of Medical History, vol. i, No. 4, 
p. 374- 



what I took to be a carious spot in the lower 
premolar of a three-toed horse. Examination 
of the specimen, however, reveals the fact 
that the defect is a post-fossilization fracture 
and is not due to disease. Mr. Anderson at 
the American Museum, showed me some 
thin sections of a tusk of Mastodon obscurus 
which showed undoubted carious spots 
along the edge of the dentine. The pa- 
thology is, however, not common. 

Regeneration. — This phenomenon is essen- 
tially not pathological but that it often fol- 
lows traumatism, is my excuse for mention- 
ing it here. Mr. Frank Springer at the 
United States National Museum showed me 
some Silurian crinoids which had apparently 
had an arm broken or bitten off and in the 
process of regeneration often two arms took 
the place of the lost one, the regenerated 
arms being usually smaller than the normal 
ones. Mr. A. H. Clark, of the same institu- 
tion, has lately made a study of the pathol- 
ogy of recent crinoids, and his results will be 
incorporated in Volume II of his forthcom- 
ing "Monograph of Existing Crinoidea." 

Necrosis. — The huge glyptodonts of the 
Pliocene and Pleistocene of South America, 
in spite of their heavy armoring of bone 
on skull, body and tail, were often sub- 
jected to injuries which became infected 
and produced extensive necroses in the 
bony carapace. Doctor Sinclair of Prince- 
ton suggests that these necrotic sinuses 
were caused by injuries from thej_saber- 
toothed cat, which in attacking the glypto- 
dont and finding himself baffled by the 
bony armor, clawed and bit the carapace 
of the beast. If the giant Pleistocene cat's 
teeth and claws were as septic as the mod- 
ern house cat's are reputed to be, sepsis 
may well have followed such an attack. 
Similar necrotic sinuses were seen in the 
dermal plates of the giant dinosaur, Stego- 
saurus, which bore a huge armament above 
his vertebral column. 

Opisthotonos. — Paleontologists on the 
whole are decidedly averse to accepting the 



New Observations in Paleopathology 



245 



writer's ideas that fossil animals preserved 
in the opisthotonos, pleurothotonos and 
emprosthotonos, were the victims of dis- 
ease. One pitfall in the acceptance of this 
idea is that they all regard these phenomena 
as being restricted to man, not knowing, as 
every sophomore medical student knows, 
that opisthotonos, pleurothotonos and em- 
prosthotonos, in the order of frequency 
seen, are extremely common in the lab- 
oratory animals in medical schools, whether 
in pharmacology, medicine, physiology, 
pathology, or bacteriology. These phenom- 
ena are so frequently seen that no one, 
apparently, has paid any attention to them, 
for there is no medical literature on the 
subject, which makes the field a splendid 
one for investigation. The very meanings 
of the terms are in doubt. "The Century 
Dictionary" regards opisthotonos as a dis- 
ease, which it clearly is not. In view of this 
uncertainty in the medical world it is no 
wonder that one paleontologist, Bashford 
Dean, writing in Science, 5 should say that 
opisthotonos does not occur in mammals, 
when as a matter of fact it is extremely 
common in all forms of mammals, birds, 
amphibians, reptiles and fishes. Cats, inocu- 
lated with cerebrospinal meningitis, often 
die during the night and are fixed in the 
opisthotonic attitude by the "rigor mortis." 
If the cat were to be fossilized it would 
be in splendid condition to show the posi- 
tion in which it died, millions of years 
hence. We can only interpret the past 
by what we see at the present time, and 
if opisthotonos is an accompaniment of 
disease today, it certainly was in ancient 
times. Another convincing argument is 
that in ancient skeletons, as in modern 
forms, opisthotonos is the more common 
phenomenon, pleurothotonos being less 
commonly seen. The drying of the ligaments 
is to my mind inadequate to produce this 
position, for often heavy-headed animals 
are preserved in this attitude, and no Iiga- 
6 April 1 1, 1919. 



ment is sufficiently elastic even in life to 
draw a heavy head several feet or yards 
from its normal position. There is no data 
to prove that ligaments in drying contract, 
or, if they do, there is no data to prove that 
the dorsal ligaments would overpower the 
ventral ones. The pull is exerted by the 
muscles and tendons, and this pull is stimu- 
lated by some neurotoxin upon the nerve 
supply of these muscles while in a spastic con- 
dition. Vertebrates preserved under water 
would not be subject to drying and they 
frequently exhibit the above phenomena. 

Fractures. — This form of traumatism is 
extremely common among fossil verte- 
brates, more so in some forms than in 
others. Nearly every modern phase of 
fractures is to be seen among ancient ani- 
mals, the form of the skeleton, of course, 
modifying the pathology. A skull fracture, 
for instance, in an ancient teleosaur, a long- 
snouted crocodile-like creature, would not 
be of the same nature as a skull fracture in 
man. Fractures are especially common in 
the skeletons of Moropus, a large, heavy, 
clawed ungulate of the Tertiary, with much 
the appearance of a horse, though the fore 
limbs are longer than the hind, and are pro- 
vided with huge claws. These Chalicother- 
oidea must have had a pugnacious dis- 
position, for they suffered many severe 
fractures of the skeleton. There are many 
dozens of fractures evident among the 
five or six thousand bones of this genus 
preserved in the American Museum of 
Natural History. Fractures in this animal 
are interesting to the paleontologist as 
indicating something of the habits of life 
of the animals; but to the medical man the 
fractures are interesting in the form of 
pathology which is evident. Fractures in 
the skeleton of this -beast will be described 
and illustrated in the forthcoming treatise 
on paleopathology. 

Paleopathology, as Depicted on Ancient 
Peruvian Pottery. — Ruffer especially has 
called attention to the representation of 



246 



Annals of Medical History 



certain forms of pathology among the 
ancient Egyptians, in their stelse, tomb 
sculpturing and other archeological objects; 
and his results, as well as those of Ham- 
burger and Charcot, are well known. It is 
perhaps not so well known that the ancient 
inhabitants of Peru had a similar custom, 
although attention has been called to these 
objects by the South American writers, 
Tello, Tomayo, de Palma, Escomel and 
others, and by the American, Ashmead. 
An important fact in this mode of preserva- 
tion of medical history is that dermato- 
Iogical lesions, which would be lost on the 
bones, are often clearly depicted on the 
"huacos" as the water jars are called. The 
most common disease represented on the 
ancient pottery is the "uta," the etiology 
of which has been so admirably described 
by Strong and his associates in their report 
of the Harvard expedition to Peru in 191 3. 
This disease, distributed in America, from 
Argentine to central Mexico, properly a 
form of Ieishmaniosis, attacks chiefly the 
lips and nose, eating away the nasal car- 
tilages and the entire lip. Some potteries 
depict a smooth clean cut surface of the 
upper lip suggesting that a form of pre- 
historic amputation of the lip was per- 
formed to prevent the further spread of the 
disease. A photograph of one of these pots 
placed alongside of a photograph of a recent 
advanced case of "uta" is strikingly sim- 
ilar in all the horrid aspects. The disease 
is a very loathsome one, and is very com- 
mon in Peru to-day. Another disease, which 
so far as I know does not occur in Peru 
to-day, depicted on these ancient water jars 
is that of "goundou" or "gundu," a tropical 
disease seen in Africa and recently de- 
scribed by Schlagenhaufen from Malaysia. 
It is characterized by a swelling at the base 
of the nasal bones, giving the root of the 
nose a bulbous appearance. This same 
pathology has been noticed by LetuIIe in an 
ancient Peruvian skull from Ancon. Ash- 
mead has figured a curious piece of pottery 



representing a dwarf, of the achondro- 
plastic type, whose body is covered with 
skin lesions resembling those described by 
Strong as Verruga Peruviana, the etiology 
of which is given in the Harvard report. 
The disease is confined to South America 
and has doubtless been in existence there 
for many centuries. Amputation of the 
limbs was performed by prehistoric sur- 
geons in ancient Peru, as seen in the figures 
depicted on these ancient water jars. An 
interesting example of this is in the Ameri- 
can Museum of Natural History, where the 
seated figure is examining a bone cap which 
he is about to place over the amputated 
stump. These caps are often depicted in 
dances, indicating a means of equalizing 
the length of the limbs. A most interesting 
relic of ancient parasitism is that seen in a 
pair of curious water jars where human 
figures are seen examining the soles of their 
feet which are covered with large rounded 
openings. At the present day there is a 
tick known as the "nigua" which infests 
sandy places and deposits its egg sacs in the 
bare feet of the Indians. If these egg sacs 
are not entirely removed serious results 
follow. The ancient water jars then depict 
the results of the removal of these egg sacs 
in ancient times. The archeological evi- 
dences of paleopathology are thus seen to 
provide a new and rich field of study. 
There have been occasional incursions into 
this territory, but the whole subject has 
never been adequately discussed. 

Crinoid Tumors. — The swellings in crin- 
oid stems, often termed "galls," indicate 
in some cases infections by parasitic worms; 
but the care with which the interpretation 
must be made is evident from the fact that 
Fig. 4 of my paper "Studies in Paleopath- 
ology," depicted as a crinoid tumor, is not a 
tumor at all, but a geode, as I suggested it 
might be. Geodes are very commonly 
formed in crinoid stems and often resemble 
these crinoid galls. Etheridge and Graff are 
the students who have described these 



New Observations in Paleopathology 



247 



galls in ancient crinoid stems, but so far as 
I could discover true crinoid "galls" are not 
known from American deposits. 

Ankylosed Atlas. — Skulls, with the atlas 
ankylosed more or less firmly to it, have 
been frequently described by writers on 
paleopathology who have ascribed the union 
to Spondylitis deformans. An examination 
of a series of skulls in the United States 
National Museum, however, proves con- 
clusively that this phenomenon is not one 
of disease at all, but a question of develop- 
mental anomaly. Anthropologists are not 
yet clear as to the meaning of this ankylosis, 
but it is clearly not a pathological problem. 
It is true that absence of parts of the atlas 
may result in pathology, since the con- 
genital absence of the anterior arch of the 
atlas may result in paralysis, by pressure 
of the odontoid upon the medulla. 

The Origin oj Disease. — Some paleontol- 
ogists are of the opinion that disease arose 
coincidently with animal and plant life on 
earth. Dr. John M. Clarke of Albany has 
suggested that the student of invertebrate 
fossils, which were the earliest types of 
animals, is seldom confronted by the ob- 
vious lesions such as are so frequently in 
evidence among the vertebrate remains. 
There have frequently been recorded lesions 
on the shells of brachiopods, cephalopods, 
and Iamellibranchs, which may have been 
due to injuries to the mantle, caused more 
frequently by parasitic attacks than by 
external accidents. There have been many 
cases observed which have never been 
recorded, and often paleontologists, chiefly 
interested in the specific determination of 
the forms, have cast aside as useless the 
injured and diseased fossils. It is not unusual 
to find abnormal growths in the structure 
of the hinge line in the Iamellibranchs, and 
occasionally in the development of such 
delicate organs as the calcified brachial 



supports of the brachiopods. The network 
of the ancient glass sponges is often torn 
and repaired, lesions which are probably 
entirely accidental. Among the simpler 
forms of the earlier faunas, among which 
we may look for evidences of the origin of 
disease, pathologic conditions seem to be 
intimated by biological interdependence 
which may eventuate in total dependence 
or true parasitism. Examples of true parasi- 
tism are known from the Devonian. Dr. 
Clarke concludes: "It is, however, indi- 
cated from present evidence that the world 
of life, in the earlier stages of its history, 
was comparatively free of associations which 
might be construed as pathological except, 
of course, so far as the activity of bacteria 
is concerned. Here is a large and wide-open 
field of great interest and very important 
bearings." 

Multiple Arthritis in a Mosasaur. — Mr. 
H. T. Martin of Kansas University has 
recently loaned me for study a nearly com- 
plete series of the left hallux of a large 
mosasaur, Platecarpus, from the Cretaceous 
of Kansas, showing extensive arthritic 
lesions in all the joints of the toe. The 
metatarsal is especially pathologic, flat- 
tened, shortened, necrotic and covered 
with a carious roughening. When compared 
with a normal metatarsal the pathology is 
very evident. Each successive joint is 
deformed, enlarged, necrotic, with the arti- 
cular ends of the phalanges lipped, similar 
to the lipping observed in arthritis in human 
skeletons. This is the first known example of 
multiple arthritis in a fossil vertebrate. 
The primary lesion was doubtless at the 
metacarpotarsal junction. Whether the 
other lesions are to be regarded as metas- 
tases is uncertain. Microscopic study of the 
lesions will be made and the specimen will 
be more carefully described and illustrated 
later. 



JEAN PAUL MARAT, PHYSICIAN, REVOLUTIONIST, PARANOIAC 1 

By CHARLES W. BURR, M.D. 

Professor of Mental Diseases, University of Pennsylvania 
PHILADELPHIA, PA. 



JEAN Paul Mara (the final "t" was 
added later) was born on May 24, 
1743, in the village of Boudry, now 
in the Swiss canton of Neuchatel, 
but then a fief of the Prussian 
crown. His racial stock — human breeds in- 
termixed to make him — is unrecorded. His 
father, about whom little is known, mi- 
grated from Sardinia, and during his life 
worked at several occupations, being in 
turn a chemist, a designer, and a teacher 
of languages. His mother, of whom also 
little is known, had a French father. One 
of her neighbors evidently had a very bad 
opinion of her, because, when the Marats 
moved to Geneva, she sent after them an 
anonymous letter accusing Mrs. Marat of 
possessing a diabolical tongue, of being a 
most notorious liar, a woman of no charac- 
ter, and of having a husband who was a 
downright hypocrite and a canting humbug. 
The letter throws more light on the charac- 
ter of the writer than on that of Mrs. Marat, 
who was far from deserving such a casti- 
gation, while her accuser was, in theological 
language, possessed by a devil, or, in 
scientific language, so poisoned by the 
toxins of anger, that reason abdicated and 
uncurbed emotion ruled. 

We possess little data as to Marat's 
family inheritance and in consequence are 
ignorant of the real causes of his being the 
man he was. We also know but little of the 
environmental influences to which he was 
subjected in childhood and youth. In later 
life he gave in the Journal de la Republique 
Frangaise the following, almost wholly sub- 
jective, autobiographical account, which is 
to be taken with several grains, indeed 
many bushels, of salt. He writes : 

1 Read at the College of Physicians, November 6, 
1918. 



248 



"Born with an impressionable nature, 
a fiery imagination, a hot, frank, and 
tenacious temperament, an upright mind, 
a heart open to every lofty passion, and 
above all to the love of fame, I have 
never done anything to pervert or destroy 
these gifts of nature, but have done 
everything to cultivate them. 

"By an exceptional good fortune I 
have had the advantages of receiving a 
careful education in my father's house, 
of escaping all the vicious habits of child- 
hood that enervate and degrade a man, 
of avoiding all the excesses of youth, and 
of arriving at manhood without having 
abandoned myself to the whirlwind of 
the passions. I was pure at the age of 
twenty-one, and had already for a long 
time past been given to the meditation 
of the study. The only passion that 
devoured my mind was the love of fame; 
but as yet it was only a fire smouldering 
under the ashes. The stamp of my mind 
had been impressed upon me by nature, 
but it is to my mother that I owe the 
development of my character. This good 
woman, whose loss I still deplore, trained 
my early years; she alone caused benevo- 
lence to expand in my heart. It was 
through my hands that she caused the 
succor that she gave to the indigent to 
pass, and the tone of interest she dis- 
played in speaking with them inspired 
me with her own feelings. 

"Upon the love of humanity is based 
the love of justice, for the notion of what 
is just comes from sentiment as much as 
from reason. My moral sense was already 
developed at the age of eight. Even then, 
I could not bear to behold ill-treatment 
practiced upon another; the sight of 
cruelty filled me with indignation, and 



Jean Paul Marat, Physician, Revolutionist, Paranoiac 



249 



an injustice always made my blood boil 
with a feeling as of a personal outrage. 

"During my early years, my consti- 
tution was very delicate; moreover, I 
never knew either petulance or obstinancy 
or the games of childhood. Docile and 
diligent, my masters obtained everything 
from me by gentleness. I was only 
chastised once, and the resentment at an 
unjust humiliation made such an im- 
pression upon me that it was found 
impossible to bring me again under my 
instructor's authority. I remained two 
whole days without taking nourishment. 
I was then eleven years old, and the 
strength of my character may be esti- 
mated from this single trait. My parents 
not having been able to bend me, and the 
paternal authority believing itself com- 
promised, I was locked up in a room; 
unable to resist the indignation that 
choked me, T opened the casement and 
flung myself into the street; happily the 
casement was not high, but I did not fail 
to hurt myself seriously in the fall, and 
bear the mark on my forehead to this 
day. 

"The shallow men who reproach me 
with being a 'tete' (obstinate fellow) 
will see from this that I was such at an 
early age; but they will refuse perhaps to 
believe that at this time of life I was 
devoured by the love of fame; a passion 
that has often changed its object at 
different periods of my life, but which 
has never quitted me for a moment. 
At five years of age I wanted to be a school 
master; at fifteen a professor; at eighteen 
an author; and at twenty a creative 
genius. This is what nature and the 
lessons of my childhood have made me. 
Circumstances and reflection have done 
the rest. I was reflective at fifteen, a 
thinker at twenty-one. At the age of 
ten I contracted the habit of a studious 
life; mental work had become a veritable 
necessity for me, even in illness, and my 



greatest pleasures I have found in medi- 
tation." 

He paints himself as perfect, a satisfied 
self-worshipper. 

Almost no man, and certainly no one of 
histrionic temperament, ever writes of the 




Jean_Paul^Marat, born 1743, murdered 1793. 

psychical experiences of his boyhood truth- 
fully; he looks back at them through the 
mist of illusions of memory, is a victim of 
paramnesia, remembers things that never 
happened, because he has the will to believe 
in their reality, credits ideas, opinions, 
and emotions of his adult life to an earlier 
time. I doubt not, Marat described his 
early mental life, his psychical development, 
as he believed it to have been, but he so 
believed because he wanted such a boy- 
hood; he was, to himself, his image of a 
hero, and as such he paints himself. To the 
psychiatrist what he wrote is valuable, 
because it reveals his nature all uncon- 
ciously to himself — the vanity of the man, 
his self-centeredness, his feeling of being 
persecuted, his feminineness in mistaking 



250 



Annals oj Medical History 



feeling for thought, mistaking intuition, 
which is really emotional guessing, for 
ratiocination, and his worship of words. 
His writings so accurately portray his 
mental makeup, his temperament and char- 
acter, that I have, at the risk of being 
almost unbearably boresome, quoted quite 
extensively from this source. In drawing 
conclusions, however, we, who are of 
British inheritance, must remember that 
in France, especially during the Revolu- 
tionary period, it was quite the proper 
thing not to be restrained, reserved, in 
talking or writing about one's self, but to 
take, or pretend to take, the hearer or 
reader to one's bosom. He may have been 
precocious, he probably was; but precocity 
means premature rotting as well as apparent 
premature ripening. Normal men do not 
believe that their moral sense was "dev- 
eloped at the age of eight," and do not 
boast of having thrown themselves out of 
windows at eleven because their parents 
punished them. Healthy children are not 
devoured by the love of fame. 

Whatever Marat's heredity may have 
been, his parents were kind, and realized 
the value of education. Whether his home 
environment was of the wisest, we do not 
know, but in childhood and youth he cer- 
tainly escaped the interference with his 
mental growth which many fear the Ameri- 
can boy of the twentieth century will not 
escape. Outside, conditions probably were 
commonplace. At about his seventeenth 
year he left home to seek university learn- 
ing, apparently with the definite idea of 
becoming a physician. This proves that he 
had qualities far above the average youth, 
but, like many another paranoiac in the 
making, he worshipped the tongue in 
action and measured professorial wisdom 
by the rapidity of the flow of words from 
the professorial mouth. He studied at 
Toulouse, Bordeaux, Paris, London, and in 
Holland. About 1765 he started to practice 
medicine in Church Street, London, and 



remained there approximately twelve years. 
It is unknown when and where he got his 
first degree in medicine, but in 1775 he was 
granted a kind of honorary degree of doctor 
of medicine by the University of St. Andrews 
at the request of two physicians, Dr. Hugh 
James and Dr. William Buchan. It was not 
unusual to confer such a degree at that 
time, and the granting of it carried no 
connotation of distinction or eminence. 

While in London he wrote much on 
scientific and philosophic subjects. His 
first work was "An Essay on the Human 
Soul" which he later expanded into "A 
Philosophical Essay on Man, or the Prin- 
ciples and the Laws of the Influence of the 
Soul on the Body and the Body on the 
Soul." Such books appeal to minds of a 
certain type and continue to be published, 
even in this day of assumed greater knowl- 
edge and wisdom. Another book was "The 
Discoveries of M. Marat on Fire, Electricity 
and Light," which received honorable men- 
tion and approbation from the French 
Academy. He published during the same 
period pamphlets on a "Singular Disease of 
the Eyes" and "An Essay on Gleets," both 
of which are wholly sane in manner and 
matter, but not in the least remarkable ex- 
cept for his boastful claim of ability to cure 
any case of gleet. Since, however, some phy- 
sicians of our own day do not hesitate to 
admit the same belief in their infallibility 
without being accused of mental abnormal- 
ity, we must not hastily draw conclusions 
about Marat. 

The following extract from his philo- 
sophical essay is of interest as showing his 
scholastic viewpoint. He, as is quite natural 
when we consider the age in which he lived, 
accepts as correct the division of man into 
soul and body. In searching for the dwelling 
place of the soul, without, however, having 
first defined what the soul is, he concludes: 

"Anatomists agree that we must look 
for the seat of the soul in the head; but 



Jean Paul Marat, Physician, Revolutionist, Paranoiac 



251 



they are not unanimous as to what place 
it occupies in that part of the body. 
Some place it in the pineal gland, others 
in the corpus callosum, others again in 
the cerebrum; some in the cerebellum, 
and some in the meninges. But of these 
different opinions, the last one is well 
founded; for, if we trace the nerves to 
their entrance into the membranes of the 
brain, we shall find they confound them- 
selves with the meninges, and form one 
simple uniform substance with them. 

"Hence, if the nerves only are sensible 
and if the sensations are not continued 
to the soul by these organs, we plainly 
perceive that the meninges must be 
esteemed the seat of the soul. For as the 
membranes and their productions are the 
general organs of sensation of the body, 
its seat must be in that part where the 
concourse appears, viz., at the centre of 
all the organs of sensation: these mem- 
branes are this centre. 

"Experience likewise daily confirms it; 
the slightest inflammation of the men- 
inges occasions a delirium, and a tem- 
porary insanity. The irritation of the 
nerves, by the fumes of wine from drink- 
ing to excess, or by the fumes of tobacco, 
is followed by the irritation of the 
meninges, and the loss of reason; this 
never happens to any other part of the 
head. 

"The substance of the cerebrum or 
cerebellum may be taken from a living 
animal without the soul's being instantly 
affected; and though the wounds of the 
centre of the brain, of the pineal gland, 
and of the corpus callosum sometimes 
injure the functions of the soul, it is not 
because the seat of the mind is in either 
of these parts, but because these parts 
secrete a fluid which is necessary to its 
operations, and by reason of the irritation 
which wounds in these parts communicate 
to the meninges. In these membranes 
Eternal Wisdom has placed the soul, and 



united it to our organs by imperceptible 
bands; here it has fixed the seat of 
thought, of memory, and of will." 

The following written years before he 
became a leader of the mob, is of interest 
when one considers his own conduct in 
later life. 

"Such as are brought up in an excess 
of delicacy, and a continual habit of 
indulging themselves in every sort of 
pleasure, are not affected by the suf- 
ferings of others: their sensibility is con- 
stantly employed on themselves; they 
are altogether unconcerned about other 
beings, and their hearts are steeled 
against the sufferings of mankind. In 
proportion as this love of self increases, 
pity decays, and frequently becomes 
extinct. He who melts into tears at the 
distress of the unfortunate, were he his 
enemy, instead of alleviating would ag- 
gravate his misfortune. 

"Nero, who wished he had never 
learned to write when pressed to sign the 
warrant for a criminal's execution, could 
delight in the murder of his enemies. 
This tyrant, who loudly bewailed the 
fate of Andromache as presented on the 
stage, could hear without emotion the 
cries of those he had doomed to des- 
truction. 

"Pity is destroyed by the passions; it 
is even generated in the heart only by 
prudent reflection, is nourished only by 
tender sentiments, and is wholly ex- 
tinguished by the frequency of those ob- 
jects which ought naturally to confirm 
it. Let us suppose a man has never heard 
anyone discourse on ideas of justice, 
goodness, clemency, and generosity; he 
must remain forever ignorant of the very 
names of those virtues. 

"By a frequent attendance at those 
bloody feasts, which in some great cities 
are given by avarice to idleness, you will 
soon lose all sense of the strong emotions 



252 



Annals oj Medical History 



you had hitherto felt at the cries of the 
mangled animals; in time you will hear 
them with pleasure, and wait impatiently 
for a repetition of them. By frequenting 
such scenes, the soul becomes callous to 
impressions, is unaffected by the pros- 
pect of human miseries, and insensible 
to every tender emotion. Do not these 
reasons prove that pity is not a native of 
the human breast?" 

Voltaire, who certainly had a clear head 
and much learning, as well as a caustic wit, 
did not hold Marat in high esteem as an 
explainer of the universe. In one place 
Marat, giving himself up unrestrainedly 
as he had a habit of doing, to the enjoyment 
of fine writing, i.e., writing which is sono- 
rous but meaningless, refers rather em- 
phatically to thought making a man enjoy 
nothingness. Voltaire comments: "It 
(nothingness) is a great empire; reign there, 
but insult a little less those who are some- 
thing." Marat said Voltaire's contemptuous 
attitude was caused by grief at seeing him- 
self put in his proper place in the "Essay on 
Man." This little incident is an example of 
how small a thing may throw a bright light 
on a man's nature. Marat believed he had 
a much greater intellect than Voltaire. 

His first political book, entitled "Chains 
of Slavery," "a work wherein the clandes- 
tine and villainous attempts of princes to 
ruin liberty are pointed out and the dread- 
ful scenes of despotism disclosed," was pub- 
lished in 1774. Its purpose was "to secure 
the triumph of liberty in England," "to 
paint the inestimable advantages of liberty, 
the frightful evils of despotism." The title, 
which is too long to quote in full, is sug- 
gestive to the psychiatrist, because political 
paranoiacs of the book-writing class are 
prone to long descriptive titles, and revel 
in the words despotism, villainy, liberty, 
tyranny, and such phrases as "the people's 
friend," "the wickedness of kings," "the 
sinfulness of the rich," and the like. Every 



collection of such books shows a family 
likeness in all the title pages. In describing 
the making of the book he says — and. I 
quote him verbatim — he devoured thirty 
volumes, worked twenty-one hours a day 
for three months, and kept himself going by 
drinking excessive quantities of coffee. Like 
many of the writers and teachers of the 
newer sociology of today, he imagined that 
all that is necessary to become an expert on 
any subject is to read some books, take pen, 
and let the ink flow. Such men lack the 
ability to meditate, they do not know what 
meditation means: it is outside their world. 
Immediately on completion of the book he 
fell ill became stuporous, dazed, lost all 
power of memory, and was miserably weak 
physically. He recovered in thirteen days 
"by aid of music and repose." It is note- 
worthy, in the psychology of authorship, 
that men who make great, fundamental dis- 
coveries in science, or who by their writings 
on political matters help this poor old world 
along to wherever it may be going, are not 
broken by their labors and never become 
hysterical or histrionic, while the gentlemen 
who continuously, in print or on the plat- 
form, protest their love of the people, 
without ever in any way helping us by good 
deeds, are very prone to hysterical disorders. 
We have had illustrations of this in our 
recent political history, in men who have 
bulked momentarily large in the public eye. 
The explanation is simple: such men over- 
work their emotions and think they are 
overworking intellect; they are feeling, not 
thinking animals. The real thinkers are 
not troubled by unruly emotions concerning 
the things they write about, and have 
other outlets for their emotions. 

Light is thrown on Marat's mental nature 
by his description of his troubles, many of 
them largely imagined, but all having a 
foundation of fact, in getting "The Chains 
of Slavery" printed. The book was written 
to show the wickedness of Lord North and 
his administration of the British Govern- 



Jean Paul Marat, Physician, Revolutionist, Paranoiac 



253 



ment. It never entered Marat's head, so con- 
vinced was he that he was a savior whose 
mission was to free unconscious slaves, 
that the English people might regard it as 
an impertinence, if indeed the mass of them 
thought of the matter at all, for an unknown 
and rather ignorant foreigner to attempt to 
advise them how they should govern their 
country. He was astonished that when he 
offered the book to the printers no one cared 
to publish it. Several gave no reason; but one, 
Woodfall, suggested that the introduction 
was of a nature to give offence in powerful 
quarters. This explained matters to Marat; 
the printer, he was convinced, was bought 
up. The fact that the Prince of Wales' 
bookseller wished his name struck off the 
list of subscribers, strengthened his belief 
in a conspiracy. Marat tells us he "became 
heroic." He slept for six weeks with a brace 
of pistols under his pillow, in order that 
he might receive in proper fashion any 
minion of the state who might be sent to 
seize his papers. Notwithstanding his 
preparations nothing happened, and he 
concluded that the British government, 
having learned of his determination to pro- 
tect his papers even by gunfire, had decided 
to use cunning instead of brute force. 
Finding publication in the ordinary way 
impossible, he decided to send copies to the 
so-called patriotic societies in the north of 
England. But, as he believed, Lord North 
heard of this, surrounded him with spies, 
tried to corrupt his servants and his land- 
lord, intercepted his family letters, and 
indeed used the whole governmental ma- 
chinery to stop the circulation of the book. 
Marat then determined to put the govern- 
ment off its guard by disappearing. He 
accordingly went to Holland and imme- 
diately returned to the north of England, 
where he visited all the patriotic societies, 
this bit of childish cunning being, in his 
opinion, enough to mystify all the English 
spies and_detectives. All of the societies 
gave him the civic crown, and one even 



insisted on contributing to the cost of 
printing the book which Marat believed the 
British government had spent eight thou- 
sand guineas in suppressing. The only com- 
ment one can make is that though Lord 
North may not have been, indeed was not, 
the wisest of men, and certainly was more 
than unfriendly to Marat, he was not the 
sort of man to value Marat at any such 
price. He may have spent eight thousand 
shillings of the taxpayers' money in the 
suppression of free speech by Marat, but it 
is doubtful. If he did he wasted money. 

In 1777 an incongruous event happened 
in the life of him who was later to be self- 
styled "the people's friend." He became 
physician to the Garde du Corps in the 
Comte d'Artois' household. Writers who 
do not approve of him state incorrectly, 
and rather maliciously, that his real position 
in the household was that of a horse doctor. 
Having obtained the position, he desired to 
prove his own right of nobility, feeling he 
properly belonged to the same class whose 
company he was keeping, and he wrote to 
the chief of the heraldry office about the 
matter. The hater of despotism and the 
believer in the equality of men took service 
under an aristocrat of the first water and 
wanted the bauble of nobility himself. He 
doubtless held with Emerson, before Emer- 
son was born, that consistency is the bug- 
bear of little minds. He retained this posi- 
tion till 1786. Meanwhile he wrote much 
on scientific subjects — on light, fire, elec- 
tricity, optics. None of these writings are 
remarkable and they did not aid the prog- 
ress of science in any way. He did, however, 
at that time, have a real desire for knowl- 
edge. His scientific and medical writings 
were not a pose, but were honestly written 
by a man interested, and somewhat trained, 
in scientific matters. His own opinion of his 
position in the world of science is revealed 
by him in the following quotation: "Cal- 
umny has flown from Paris to the Escorial 
to blacken me in the mind of a great king 



254 



Annals oj Medical History 



and an illustrious Maecenas. Who are my 
detractors? Envious cowards, the numerous 
crowd of whom does not cease to devote 
itself to my destruction — modern philoso- 
phers, hidden under anonymity or false 
names in order to defame me. Scarcely had 
I attained the age of eighteen, when our pre- 
tended philosophers made various attempts 
to drag me into their party." He was sure 
one of his books was prohibited in France 
because certain French philosophers were 
envious of him. What he thought of himself 
as a physician the following quotations will 
show. "Many sick persons," he says, "of 
distinguished rank, who were despaired of 
by their physicians, and to whom I had 
restored health, joined with my friends in 
endeavoring to induce me to fix my abode in 
the capital. I acceded to their persuasions; 
they promised me fortune, I have found 
only outrage, annoyance, and trouble." 

"The fame of the surprising cures I 
have made," he continues, "drew to me a 
prodigious crowd of sick people; my door 
was continually assailed by the carriages 
of persons who came to consult me from 
every quarter. As I exercised my art as 
a physician, the knowledge of Nature 
gave me great advantage, no less then 
my swiftness of eye and accuracy of 
touch, and my multiplied successes caused 
me to be called 'the physician of the 
incurable.' . . . My successes gave um- 
brage to the doctors of the Faculty, who 
calculated with sorrow the big amount of 
my profits. [I may say parenthetically, he 
never made any money, never tried to, 
was careless about money and financially 
honest. He died almost penniless.] They 
consoled themselves by forming a project 
to dry up their source. I could prove, if 
need be, that they held frequent meetings 
to consider the most efficacious means 
of slandering me. Henceforth, calumny 
spread in every direction, and anonymous 
letters reached my patients from all sides 



in order to alarm them with regard to 
me. A large number of persons, whose 
friendship for me is founded on esteem, 
took up my defence, it is true; but their 
voices were drowned by the clamour of 
my opponents. All these facts are matters 
of public notoriety. 

"Disgust, inseparable from the prac- 
tice of medicine, made me sigh more than 
once for the retirement of the library; I 
then gave myself up entirely to my 
favourite studies. Could I have foreseen 
that I was to make for myself a new cause 
for envy?" 

His opinion of himself as a statesman, 
and a partial catalogue of his acts, is shown 
in the following quotation: 

"All that a man of sense and a man of 
heart could do to save his country I have 
done to defend mine. Alone and without 
support, I have fought for two whole 
years against the commissioners of sec- 
tions, the municipal administrators, the 
chiefs of police, the courts of justice, the 
tribunal of state, the government, the 
prince, the National Assembly itself, 
and often with success. I have exposed 
the black designs of the court, detected 
its snares, its artifices, its plots ; I have 
disconcerted the conspirators, prepared 
the fall of Le Chatelet and brought about 
that of an adored minister. I have un- 
masked the Parisian general, raised the 
army and the fleet against their despotic 
chiefs; more than once I have compelled 
venal committees to resign, to suspend or 
to revise their projected decrees; I have 
struggled against oppressors of every 
kind; I have rescued a hundred thousand 
victims from judicial tyranny. More than 
once I have made the tyrant on his throne 
turn pale, and dismiss his frightful agents. 
Always in arms against the traitors to 
the fatherland, indignant at their crimes, 
and shocked at their atrocities, I have 
torn away their masks, I have made a 






Jean Paul Marat, Physician, Revolutionist, Paranoiac 



255 



spectacle of them, their impostures, their 
defamations; I have braved their resent- 
ment, their fury. Exposed to their wrath, 
I have been pursued again and again by 
the ministers and the municipal ad- 
ministrators. Twenty military expedi- 
tions directed against me, and a whole 
army mobilized to tear me away from 
the people, have only increased my 
audacity. A price has been put on my 
head; five cruel spies put on my tracks, 
and two thousand assassins, paid to slay 



"This kind of life, the mere recital of 
which freezes the most callous heart, I 
have led for eighteen long months with- 
out one moment complaining, without 
once asking for rest or recreation, without 
heeding the loss of my health, of my 
estate, and without blanching at the sight 
of the sword always pointed at my heart. 
What do I say? I might have been ad- 
vanced, caressed, feted, if I had been 
willing merely to keep silent, and how 
much gold would have been lavished upon 




Marat as the firebrand of the French populace. 



me, have not for an instant succeeded 
in making me betray my duty. 

"To escape the steel of the assassins, I 
have been obliged to betake myself to a 
subterranean life; hunted out from time 
to time by batallions of alguazils, com- 
pelled to flee, wandering through the 
streets in the dead of night, and often 
not knowing where to find refuge, in the 
midst of weapons pleading the cause of 
liberty, defending the oppressed with 
my head on the block, and thus growing 
ever more redoubtable to our oppressors 
and the public rascals. 



me if I had been willing to dishonor my 
pen. I have repulsed the corrupting 
metal, I have lived in poverty, I have 
preserved my heart pure. I might have 
been a millionaire today if I had been 
less scrupulous and if I had not always 
forgotten myself. 

"But I am going to abandon to my credi- 
tors the remains of the little which I have 
left, and without money, without assist- 
ance, without resources, I shall betake 
myself to vegetate in the only corner of 
the earth where I may still breathe in 
peace. Preceded by the clamors of cal- 



256 



Annals of Medical History 



umny, defamed by the public rascals 
whom I have unmasked, loaded with the 
curses of all enemies of our country, ab- 
horred by the great and by men in power, 
and set down by all ministerial cabinets 
as a monster to be stifled, perhaps I shall 
be forgotten by the people to whose 
advantages I have immolated myself; 
happy if the regrets of patriots accom- 
pany me; but I take with me the hon- 
orable testimony of my conscience and I 
shall be followed by the esteem of mighty 
spirits. 

"However frightful may have been my 
fate during my long captivity, and how- 
ever sad the prospect that opens before 
me, I shall never regret the sacrifices 
that I have made for my country or the 
good that I have wished to accomplish 
for humanity. I have fought without 
ceasing till this day, and I have not de- 
serted the post of danger till it was taken 
by storm. If there is in France a single 
man of insight and determination who 
dares to reproach me with having too 
soon despaired of the public safety and 
with a lack of constancy, let him take my 
place and retain it for only a week. 

"Citizens, I ask of you neither regrets 
nor gratitude — do not even preserve the 
memory of my name; but if ever some 
unexpected turn of destiny brings you 
victory, remember to make it assured by 
taking advantage of your success, and 
never forget, to assure your triumph, the 
advice of a man whose life was devoted 
to establishing among you the reign of 
justice and liberty." 

I have quoted so largely from Marat be- 
cause the man is revealed in his writings. In 
all the quotations, though there is in every 
statement an element of truth (he was 
an important revolutionist, he did break 
many men in political life), there is shown 
pathological suspicion, a tendency to find 
evil in all men who would not follow his 



leadership, a total inability to measure 
himself correctly, intense egoism and mega- 
lomania. Political biography does not reveal 
any man who more strongly believed in 
government by murder than Marat. He 
was not a hypocrite, but firmly believed 
that the whole art, craft and mystery of 
statesmanship consisted in enraging the 
populace so that they would destroy. 

Though "The Chains of Slavery" was 
written in 1774 and the first edition of "A 
Plan of Criminal Legislation" in 1780, it 
was about 1 788 or 1 789, the year of the fall 
of the Bastille, that he became a politician 
pure and simple and proceeded to attempt 
the task of saving humanity by preaching 
killing. He was a product of Rousseauism — 
Rousseauism filtered through a paranoiac 
brain. 

I have not time to recite the political 
doctrines of Marat. Everyone knows them. 
He spread them by orations and by his 
paper, The Friend 0/ the People. The 
people, according to him, meant only the 
propertyless and those without any occu- 
pation. They alone had the right to govern 
and to own, because, according to his 
philosophy, they alone produced and origi- 
nated all wealth. He made each difference 
of political opinion the occasion of a per- 
sonal quarrel. If anyone disagreed with 
him that person was a scoundrel, a crimi- 
nal, a murderer; he could not conceive that 
any man might hold views unlike his own 
and yet be honest. He had almost no friends, 
though many followers, and his judgment 
of men was almost always wrong. For 
example, on Mirabeau's death he wrote: 
"People, give thanks to God. Your most 
redoubtable enemy has fallen beneath the 
scythe of fate. Riquetti is no more; he dies a 
victim of his numerous treasons, victim of 
his atrocious accomplices. . . . Adroit 
rogues, to be found in all circles, have sought 
to play upon your pity, and already duped 
with their false discourse you regret this 
traitor as the most zealous of your defen- 



Jean Paul Marat, Physician, Revolutionist, Paranoiac 



257 



ders." This is his sincere opinion of a states- 
man whom sane Frenchmen had hoped 
would live, knowing that he alone could 
chain the wild men and thieves who were 
ruining the country. Marat had no con- 
ception of constructive statemanship; all 
his opinions were destructive and hence he 
could not in any degree comprehend a man 
of Mirabeau's type. Mirabeau knew that 
there are natural political laws, just as 
there are natural physical laws. Marat 
could not conceive this. Though he had 
been trained a little in natural science, his 
intellect was not of the kind that could really 
form a conception of the meaning of a 
natural law. He could not conceive in- 
evitability. Mentally, in his earlier life in 
many ways he resembled the sentimental 
sympathizers with Bolshevism who are 
to-day making so much noise in America. 
It is noteworthy that almost all the Ameri- 
can born among them have led shielded 
lives, have never been in contact with the 
realities of life, have never had to work 
(their fathers did that for them) ; the women 
advocates have failed in woman's first and 
natural function. Among the foreign born 
are internationalists, parasites, and those 
who left the countries of their birth for their 
countries' good. 

It is not easy to discover much about his 
physical appearance. No one has given an 
unbiased, unemotional description. Carlyle, 
who was not a historian, but a master of a 
certain dramatic style, an artist, and who 
thought, probably correctly, that truth is 
greater than fact, describes him as a "large- 
headed, smoke-bleared, dwarfish individual 
with blue lips." A contemporary says he was 
five feet high, with bow legs, a very large 
head, and aquiline nose. Fleischmann, a 
recent writer, says he had brilliant eyes, 
full of fire, and as one cheek was higher 
than the other the two eyes were not in the 
same horizontal line. Madame Roland, an 
unfriendly and contemporary witness, re- 
lates in her memoirs that his open shirt 



showed a yellowish chest and that his long 
finger nails were filthy and his face hideous. 
Dr. John Moore, a sane observer, who trav- 
eled in France during the Revolution and saw 
him many times, says, "Marat is a little 
man of a cadaverous complexion, and a 
countenance exceedingly expressive of his 
despotism: to a painter of massacres, 
Marat's head would be inestimable. Such 
heads are rare in this country [England], 
yet they are sometimes to be met with at 
the Old Bailey." With one quality which 
under most circumstances all men praise, 
Moore credits Marat, but damns him for 
it. He writes : "This man certainly possesses 
a great deal of courage both personal and 
political. No danger can terrify him, nothing 
can disconcert him: his heart, as well as his 
forehead, seems to be made of brass." 

From about 1789, he suffered continually 
from a skin disease which caused an ago- 
nizing pruritus. The only relief he got was 
from a continuous bath, and much of his 
writing was done while bathing. Cabanes, 
who made a very careful study of him, con- 
cludes his skin disease was eczema, that he 
was hypochondriacal, had insomnia and 
constant headaches and that all his mental 
peculiarities were largely bound up with his 
bodily suffering. Dr. C. E. Wallis quotes 
Dr. Graham Little as being of the opinion 
that the skin affection was probably a 
dermatitis herpetiformis, on the ground 
that the irritation and pain from which he 
suffered were alleviated by sitting in a bath 
of water, whereas eczema itself would have 
been aggravated by contact with water. 
Whatever his skin disease may have been, 
the agony of the pruritus was intense, and 
for years he had no relief save when in his 
tub. He stayed in it for hours, worked in it 
and was killed in it. 

A word about his murder. Charlotte 
Corday, a woman lacking three months of 
twenty-five years of age, murdered Marat 
on July 4, 1793. Her life contains nothing 
of interest save her one act of crime, which 



258 



Annals 0/ Medical History 



she believed to be an act of heroism. She 
was the daughter of a rather decayed gentle- 
man, and at the time of the Revolution was 
living in Caen. She read with all the fervor 
of the time Plutarch, Rousseau, and Vol- 
taire, and conjured up in her mind a picture 
of the Roman Republic such as never 
existed. She hoped that France would soon 
be a modern antique Rome. She was in 
sympathy with the Girondists whom Marat 
hated. She went to Paris, bought a knife, 
visited Marat while in his bath, spoke a 
few words and stabbed him, making a 
wound "between the first and second rib, 
traversing the upper part of the right lung 
as well as the aorta, and going into the left 
clavicle." He died. She tried to escape, or 
did not, according to whether you believe 
anarchists or sane men. She was made to 
confront the corpse at midnight. She bore 
the ordeal well, indeed was quite heroic, and 
said: "Yes, it was I who killed him." She 
was guillotined. Meanwhile the mob made 
a God of Marat, and then, after the fashion 
of the mob, very soon ceased to worship, in 
order to curse and destroy all memorials 
in his honor. 

Where should Marat be placed in a 
psychological classification of men? Paul 
Lacroix, some fifty years ago, wrote: 
"There were two Marats — the Marat who 
is known to everyone, and the other Marat 
whose existence no one at the present day 
suspects : the one was the pupil and admirer 
of Rousseau, the lover of nature, the 
learned author of many discoveries worthy 
of mention in chemistry and physics, the 
energetic and brilliant writer who produced 
a book of philosophy worthy of the philo- 
sopher of Geneva — the one who wrote only 
scientific, philosophical, and literary works; 
he was a doctor in the Comte d'Artois' body- 
guard; he died, or rather he disappeared, at 
the end of the year 1789, to give place to his 
namesake." G. Edward Wallis, in his 
interesting little pamphlet, explains him 
by the same assumption of two personali- 



ties: (1) the one, that of a scientist and 
philosopher, who died in 1789: (2) the 
other that of a fanatical journalist, pamph- 
leteer and demagogue. 

Dr. Cabanes seems to believe that his 
mental peculiarities were very largely the 
result of his physical ill health. Many of his 
contemporaries, not only physicians but 
also men of business and of affairs, solved 
the problem by the diagnosis of simple 
lunacy. A few writers of recent date, men in 
sympathy with his ideas, claim that far 
from being an insane man, he was a political 
genius; but one must not take them too 
seriously, because they are living in a 
mental world so topsy-turvy and in a moral 
world so vacuous that they regard crime 
as being proof of moral independence, and 
clear thinking as evidence of lack of mind. 

Lacroix and Wallis's theory of two per- 
sonalities is figurative rather than a state- 
ment of scientific fact. His case was not 
one of double personality. There was no 
break in his personality, no sudden change 
in his character. His behavior changed, not 
because he changed, but because the stimuli 
acting on him changed. He began to be 
political while still practicing medicine 
and many of his peculiarities, especially his 
megalomania, are shown even in his medical 
writings. As always happens in true para- 
noia, there was a long prodromal period, 
and it took years for his insanity to come 
to its fruition. 

I cannot altogether agree with Cabanes. 
Pruritus, no matter how severe or how con- 
tinuous, cannot cause the clinical picture 
that Marat presents. It is possible, however, 
that the pruritus was only an external 
manifestation of some disorder of meta- 
bolism, which acted not only on the nerve 
endings in the skin, but also on the cerebral 
cortical cells. This, of course, is purely 
hypothetical; but the mystery of mental 
abnormality surely will be explained on 
physical grounds. Many writers speak of 
his head as being monstrous in comparison 



Jean Paul Marat, Physician, Revolutionist, Paranoiac 



259 



with his height, which was less than five 
feet. He may have been hydrocephalic, 
or may have had some disorder of his 
pituitary gland leading to abnormal bony 
development, though his facial bones and 
hands do not indicate this (he was not 
acromegalic), and associated with it there 
may have been a congenital tendency to 
mental abnormality. He did not have the 
goodnatured temperament usually found 
accompanying disease of the pituitary body. 
The whole matter of the relation of the 
ductless glands to mental function is in a 
nebulous state; but the twentieth century 
may see proven that what one's attitude 
toward life is, how one explains the riddle 
of the universe, how one behaves, may 
depend in some degree on little glands that 
not so long ago were regarded as vestigial. 
I have said there is not time to describe 
his political life and opinions. We must, 
however, pay some attention to them. He 
started his paper, The Friend oj the People, 
at the beginning of the Revolution. He used 
it solely to abuse pretty nearly everyone, 
not only the king, the ministers and the 
nobles. He preached not revolution alone, 
which would have been entirely sane, but 
murder and general theft. He took a large 
part in arranging the proceedings of the 
mob of women who went to Versailles and 
brought the king to Paris. He urged the 
soldiers to murder the officers. Several 
times he was denounced, but always escaped 
by flight or hiding. In 1790 he was de- 
nounced, but the Cordeliers rescued him. 
Lafayette laid siege to his home, but he 
found asylum with an actress friend. In the 
same year, he proposed a law to the 
Assembly, that "eight hundred gibbets 
ought to be erected in the Tuileries to hang 
all traitors, beginning with the elder Mira- 
beau." It failed to pass. He hated the 
Gironde party. He was one of the organizers 
of the massacres in the prisons — a butchery 
which Robespierre continued under shadow 
of law. He boasted that a dictator was 



needed and that Robespierre was the one 
fit man. He declared that it was necessary 
to guillotine 270,000 people in order to free 
France. 

The gentlemen who regard him as a 
political genius, e.g., the sincere members 
of the Bolshevik party of to-day, not only 
in Russia but also in this country, are 
themselves mentally abnormal. He is not 
the only lunatic in history who has had a 
following during life and after death. 

Let us sum up his life and see whether 
we have data enough to classify him. The 
test of a man's sanity is his behavior; 
behavior being the visible signs of mental 
reaction to stimuli. When it is in consonance 
with the time in which and the place where 
a man lives, his local environment, his racial 
and his family inheritance, and his formal 
education, he is sane. Of Marat's ancestral 
history we know nothing. We know, too, 
little of his parents to form a judgment as to 
whether they were wholly normal or not. 
They surely were not noticeably abnormal 
and his young life was passed happily. It 
is true that his father worked at many 
different things in at least three countries, 
and though this makes us think of the 
possibility of his lacking fixity of purpose, 
it does not prove it. 

The time in which Marat lived de- 
termined the twist his mind was to take. 
Had he been living in America a generation 
ago he would have been an ardent, I will 
not say disciple, but rival of the leader of 
the Populists; to-day he would, if living 
in America, be a chief among the anarchists 
of the east side of New York, and probably 
would be making speeches before admiring 
audiences of gentle male and female fem- 
inists, with soft hands and softer heads, 
who think they are broadening their minds 
by listening to arguments in proof of the 
righteousness of murder, he meanwhile 
wondering how soon his real associates 
would get a chance to string his audience 
and all their relatives to nearby lampposts. 



260 



Annals of Medical History 



The French Revolution was brewing many- 
years before it came to a head, and Marat 
lived in an atmosphere of moral unrest and 
intellectual turmoil. But environment, like 
all exciting causes, requires a favoring soil 
or it will not produce insanity. The soil is 
the protoplasm as it exists in germ cell and 
sperm cell at conception. Was the soil of 
Marat's personality, his protoplasm, favor- 
able to the growth of mental disease? 
Undoubtedly, yes. He, as a youth, became 
saturated with the doctrines of Rousseau. 
Boys of other types react in other ways 
toward such doctrines, most of them merely 
negatively, not having understanding, while 
a few, those having real intellectual acumen, 
can see and have sympathy with the portion 
of truth mixed with Rousseau's emotional 
idealism. He had great, indeed, overwhelm- 
ing ambition, mediocre intelligence, infinite 
conceit, was very emotional (like the mur- 
derer who weeps to see a fly killed), had no 
real sense of justice, was a worshipper of the 
god Gab, and was entirely selfish. He had 
a little undigested learning, but no power 
of reasoning. He lived in a wild time, when 
the crooks and the cranks led the imbeciles, 
of whom there are many in every country, 
to wholesale murder. Marat wanted to be 
a leader. He believed that he could rule the 
country if only enough people were killed. 
He was shrewd enough to know, that if he 
shouted long enough and loud enough that 
he was the people's friend, many would 
believe and follow him. His creed was 
simple — all that the rich own belongs to the 
poor because they stole it from the poor. 
His theory of government was equally 
simple. If you do not agree with me you are 
not a patriot; if you are not a patriot the 
proper punishment is death. Therefore we 
will kill everybody who disagrees with us, 
and then we will have the millennium, the 
brotherhood of man. So he justified himself, 
and as time went on his murder-lust in- 
creased. His creed, thus far, would be inter- 
preted by many as indicating criminality, 



not insanity; but this opinion is unjust to 
him. 

An important and unquestionable symp- 
tom of mental disease was his delusion of 
persecution. From the time of publishing 
his "Chains of Slavery" till his death, he 
was the victim of this delusion. True, he 
had many real enemies in the Revolution 
who would gladly have killed him, but 
everyone, the English cabinet, philosophers, 
men of science, everybody, was, from his 
point of view, intriguing against him, pre- 
venting his success in medicine, stopping by 
conspiracy the sale of his scientific works, 
keeping him from political power, just 
because they envied him. Another symptom 
was his megalomania. Statecraft, which the 
wisest men of all the ages have been strug- 
gling to master, he comprehended intui- 
tively, with an infallibility of judgment 
equal to that of a god. Lacking all power 
of reasoning, of examining the facts of any 
question, weighing them and then drawing 
conclusions, he imagined he was a political 
genius, and more, a saviour of the people. 

He belongs then among the insane, and is 
an example of paranoia of the political type. 
He presents the cardinal symptoms of 
paranoia, intense egoism, delusions of per- 
secution, and an angry grandiosity. He 
has a common secondary symptom, viz., 
unlimited verbosity, the matter of his 
speeches being always the same, the wicked- 
ness of his persecutors, his own virtue, wis- 
dom, and unselfishness. He had the para- 
noiac's intensity of manner in speaking, 
and the tremendous verbal diarrhoea which 
deceives the common man, who, over- 
whelmed by the cataract of talk, goes home 
feeling that the orator must be a profound 
thinker because he talks so well. 

His moral code was wrong, and yet like 
all paranoiacs he regarded himself as vir- 
tuous. It was not a hypocritical pose. His 
career was cut short by Charlotte Corday, 
but some of his sane contemporaries say he 
would have been locked up as a madman in 



Jean Paul Marat, Physician, Revolutionist, Paranoiac 



261 



a short time had he not been killed. They 
were right, because his obsession of perse- 
cution was growing stronger and stronger 
every month in the latter part of his life. 



The alternative would have been the guillo- 
tine, which his political enemies would not 
have hesitated to use when infuriated by 
some special act of violence. 



GRAVES AT SEA 



Here I shall detail an anecdote of value, 
as furnishing an insight into the character 
of the man, and as it prepares us for under- 
standing that feature in his after-life for 
which he was justly distinguished — namely, 
his collectedness of mind and vigour of 
action in cases of difficulty and danger. He 
had embarked at Genoa, in a brig bound for 
Sicily. The captain and crew were Sicilians, 
and there were no passengers on board but 
himself and a poor Spaniard, who became 
his companion and messmate. Soon after 
quitting the land, they encountered a 
terrific gale from the north-east, with which 
the ill-found, ill-manned, and badly com- 
manded vessel soon showed herself unable 
to contend. The sails were blown out of the 
bolt-ropes, the vessel was leaking, the pumps 
choked, and the crew, in despair, gave up 
the attempt to work the ship. At this 
juncture, Graves was lying on a couch in the 
cabin, suffering under a painful malady, 
when his fellow passenger entered and, in 
terror, announced to him, that the crew 
were about to forsake the vessel; that they 
were then in the very act of getting out the 
boat; and that he had heard them say, that 
the two passengers were to be left to their 



fate. Springing from his couch, Graves flung 
on his cloak, and, looking through the cabin, 
found a heavy axe lying on the floor. This 
he seized, and, concealing it under his cloak, 
he gained the deck, and found that the 
captain and crew had nearly succeeded in 
getting the boat free from its lashings. He 
addressed the captain, declaring his opinion, 
that no boat could live in such a sea, and 
that the attempt to launch it was madness. 
He was answered by an execration, and told 
that it was a matter with which he had 
nothing to do, for that he and his companion 
should remain behind. "Then," exclaimed 
he, "if that be the case, let us all be drowned 
together. It is a pity to part good company." 
As he spoke, he struck the sides of the boat 
with his axe, and destroyed it irreparably. 
The captain drew his dagger, and would 
have rushed upon him, but quailed before 
the cool, erect, and armed man. He then 
virtually took command of the ship. He had 
the suckers of the pump withdrawn, and 
furnished by cutting from his own boots the 
leather necessary to repair the valves. The 
crew returned to their duties, the leak 
was gained on, and the vessel was saved. 
William Stokes (1854). 



AN APPRECIATION OF HENRY BENCE JONES, M.D., F.R.S. 

(1814-1873) 
By JACOB ROSENBLOOM, M.D., Ph.D. 

PITTSBURGH, PA. 



IT is now just forty-six years since Henry 
Bence Jones died, forty-six years in 
which wonderful progress has been 
made in that subject which was so dear 
to this man. He was one of the first men of 
our present era in medicine to value chem- 
istry as an aid in the explanation and cure 
of disease. 

He was born in England. William Bence 
Jones, the Irish agriculturist, was a brother. 
At twelve years of age he went to Harrow 
and at eighteen entered Trinity College, 
Cambridge. He graduated with the degree 
of B.A. in 1836, M.A. in 1842, M.B. in 1845, 
and M.D. in 1849. 

On leaving Cambridge he studied medi- 
cine at St. George's Hospital in London, 
and chemistry with Thomas Graham at 
University College. In 1841 he went to 
Giessen and studied chemistry with Liebig, 
to whom he was always attached by bonds 
of friendship and respect because of Liebig's 
wonderful work. He became licentiate of 
the Royal College of Physicians in 1842, 
fellow in 1849 and was afterwards senior 
censor. In 1842 he married his cousin Lady 
Millicent Acheson, daughter of the second 
Earl of Gosford. In 1846 he became a fellow 
of the Royal Society and was from 1 860 till 
almost the end of his life, secretary of the 
Royal Institution. In 1846 he was elected 
full physician to St. George's Hospital, 
resigning in 1862. He died at his home in 
Brook Street, Grosvenor Square, London. 

Henry Bence Jones was an accomplished 
physician and acquired a large and re- 
numerative practice. He was very well 
acquainted with the scientific men at home 
and abroad — a warm friend and admirer of 
Michael Faraday, whose life he wrote in two 
splendid volumes, and the physician and 
friend of Huxley. In Huxley's auto- 



biography he states: "In April another good 
friend, Bence Jones, lent the invalid (Hux- 
ley) his home at Folkestone for three 
months." Darwin was also a friend and 




Pencil 



sketch of Henry Bence Jones from the bust that 
stands in St. George's Hospital, London. 



patient. In the "Life and Letters of 
Charles Darwin" 1 the following passage 
discussing Jones's diet treatment is found: 
"The year 1865 was again a time of much 
ill-health, but towards the close of the year 
he began to recover under the care of the 
late Dr. Bence Jones who dieted him 

1 "Life and Letters of Charles Darwin," vol. ii, 
215. 



262 



An Appreciation of Henry Bence Jones 



263 



severely and as he (Darwin) expressed it 
'half starved him to death.'" 

Herbert Spencer was also a friend. In 
Spencer's "An Autobiography," 2 he states: 
"Speaking of drugs, Bence Jones said that 
there is scarcely one which may not under 
different conditions produce opposite 
effects." Spencer also states that Bence 
Jones approved of the bed for invalids 
which he had invented. 

Helmholtz 3 had a great deal of respect for 
Bence Jones. In speaking of his trip to 
London, he says: "In the first place, I went 
to see Bence Jones, physician, physiologist, 
and chemist, hoping to get news of du Bois 
Reymond and of the chemist Hofman. 
But he had gone off to du Bois' wedding. 
In the evening I dined at seven with Dr. 
Bence Jones. Bence Jones is a charming 
man. Simple, harmless, cordial as a child 
and extraordinarily kind to me." 

Bence Jones was also physician and friend 
of the celebrated chemist, A. W. Hofman. 
In the Hofman memorial lecture 4 the follow- 
ing incident was narrated: "One day when 
Hofman was going his usual rounds in the 
general laboratory of the Royal College of 
Chemistry, a student standing not far from 
him poured a quantity of concentrated sul- 
phuric acid into a thick glass bottle he was 
holding in his hand which contained a small 
quantity of water. The consequence was 
that the heat evolved caused it to crack and 
the bottom to fall out. Some of the acid 
splashed up from the floor into Hofman's 
eye. He had to be kept in a dark room for 
several weeks and during this time his old 
friend, Dr. Bence Jones, attended him." 

Jones was also a friend of Benjamin C. 
Brodie, as is shown by the accompanying 
reproduction of an autograph of the late 
Sir Benjamin C. Brodie inscribed in his 
autobiography which is in my possession. 

2 Herbert Spencer: "An Autobiography," vol. ii, 
106 and 174. 

3 Koenigsberger: "Life of Helmholtz," 109. 

4 Perkins: Proc. Chem. Soc, Lond. 1893. 



I have found an interesting story of con- 
sultations held in Bence Jones's time, in a 
recent book. 5 The anecdote is told by Sir T. 
Clifford Albutt. "Many years ago in the 
days of my studentship at St. George's 
Hospital, a case came under my notice 
which I see as vividly as if the patient were 
still before me. A man of some thirty or 
thirty-four years, of vigorous frame and 
apparently of vigorous constitution, lay 
propped up in bed in extreme agony. He 
complained, when he could whisper to us, 
of intense retrosternal pain, never absent, 
indeed, but returning upon him in parox- 
ysms. The pain radiated about the shoulder 
or shoulders, whether it extended lower 
down the arm I cannot remember. The 
respiration was restrained in dread. There 
were no physical signs to betray the pres- 
ence of the disease within. What I vividly 
recall as if burnt into my mind, is the aspect 
of the man, bound on a rack in the presence 
of death, and yet, for the agony at the 
centre of his being unable to cry out. Con- 
sultations were held but to little purpose, 
save to certify that the case, if one of angina 
pectoris, was a strange one, because of its 
continuous if still paroxysmal character, 
and because of the fever with it. Bence 
Jones, whom no man exceeded in brilliancy 



Ihc/rrft &fi-xZt /ais- 



lC fcLit. U,<. 



and rapidity of diagnosis, declared for acute 
aortitis. The patient died suddenly soon 
afterwards, and the necropsy justified Bence 
Jones's opinion. On the inner surface of the 
ascending aorta were groups of gray semi- 
translucent patches disfiguring the walls of 

5 "The Sensory and Motor Disorders of the Heart," 
by Alexander Morison, 1914, 91. 



264 



Annals of Medical History 



the slack and dilated vessel; and let this be 
carefully noted — no other cause of death 
could be discovered. The heart and coronary 
vessels were healthy." 

As a physician it has been said that Bence 
Jones's chief characteristics were, "Scien- 
tific truth, accuracy, and a dislike to 
empiricism." 

During the last years of his life he suffered 
great bodily weakness and at times had a 
little irritability of manner no doubt due to 
his physical ailment. As a rule he was cheer- 
ful to the last and interested in the progress 
of the Royal Institute and of science. His 
bust stands in the Royal Institute and in 
St. George's Hospital, London. 6 

The catalogue of the Royal Society shows 
thirty-four scientific memoirs credited to 
Bence Jones. He was the first to describe 
the occurrence of xanthine in urine 7 ; the 
priority of describing alkaloidal substances 
in animals is claimed by Dupre and Bence 
Jones. 8 They described an alkaloid which 

6 Obituaries: Ber. d. deut. pharm. Gesellsch. 1873, 
vi, 1585; J. Chem. Soc, Lond., 1874, xxvii, 1201. 

7 Quart. J. Chem. Soc, Lond. xv, 78. 



they separated from the solid and liquid tis- 
sues of animals and named it "animal quin- 
oidine." He was the first to describe that very 
interesting substance occurring in the urine, 
since known as the Bence Jones protein. 9 

Bence Jones's first scientific memoir was 
"On a cystic oxide calculus." 10 Besides these 
memoirs, he was the author of the following 
books: "Gravel, Calculus, and Gout; the 
Application of Liebig's Physiology to These 
Diseases," 1842; "On Animal Electricity, 
Being an Abstract of the Discoveries of 
Emil Du-Bois Reymond," 1852; "The 
Chemistry of Urine," 1857; "Lectures on 
Animal Chemistry in Its Application to 
Stomach and Renal Diseases," 1850; "Lec- 
tures on Some of the Applications of 
Chemistry and Mechanics to Pathology and 
Therapeutics," 1867; "Croonian Lectures on 
Matter and Force," 1868; and "Life and 
Letters of Faraday," two volumes, 1870. 

8 Proc. Roy. Soc, Lond., xv, 73; Ztschr. f. Chem., 
1866, 348. 

9 Proc. Roy. Soc, Lond., 1843, v, 673; "Animal 
Chemistry," 1850, p. 108; Trans. Roy. Soc, Lond., 
1848, i, 55. 

10 Med.-Chir.Tr. Lond. 1840. 




THE FINANCES OF FELIX PLATTER, PROFESSOR OF 

MEDICINE AT BALE 1 

By CHARLES GREENE CUMSTON, M.D. 2 

GENEVA, SWITZERLAND 

ABIT more than a century ago Pounds soioj^ 

—to be exact, in the year 1814 Private practice, citizens of Bale. . . . 5,031 5 "4 

.1 1 j r>- r> -j 1 Practice among foreigners 23,057 17 10 

— the learned Pierre Bndel Consultations outside the City of 

published the accounts of Felix B al e 15,050 2 9 

Platter of income received from 1558 to g^ JJ^ ysician . . ■.;;;;;; ^ 9 3 

161 2, that is to say, for the space of fifty- From the Archbishop of Bale 280 

four years. As this document was published £ rom the Commander of Bucken 80 

. / T , T e, „f,. rrom my office of surveyor of the 

in the lay press {Les htrennes Helvetiennes, m \ nt 37I x - r l 

18 1 4), it occurred to me that it might not Pension of professor 11,139 6 8 

be devoid of interest to bring it before the g™ ™ pSSKres. ". ! ! ! ! ! . ! ! ! |? \l * 

medical profession. From my published books 971 13 8 

These accounts were found among the For examinations for the Doctors of 

r . nM P , Medicine and Deanship 2,850 1 11 

papers ot the Bale prolessor, and are re- As rector of the University 339 3 4 

markable not merely for their detail, but From the Pro-Rectorate, etc 8 15 

because they enlighten us on the domestic g™ £ dS^f^l&s . .' .' \ *? 4 \ 

economy of the epoch when they were com- For showing my museum and garden 179 5 2 

puted. They show the income derived from £or my guardianships 260 

^t r T r 1 p r r or my divers stewardships 2,166 11 6 

the practice of a celebrated professor of Income from my country-seat 10,618 13 11 

medicine, the sums obtained from his bo- Sale of orange and lemon trees 1.255 6 8 

tanical garden, likewise from his silk-worm cfj e °{ Iimes and Iemons ? " I0 . 

. , , r r t • r • t- bale of rosemary 265 12 8 

industry (the first endeavor in this line Sale of plants from my botanical gar- 
made in the Canton of Bale), and even the _ den • ■ — ■ • ■ : 5 02 5 9 

c 1 • j Rent of my house and other real es- 

price of canary birds. tate.... ..29,296 9 

I here transcribe in extenso the accounts. Legacies 350 

Let me just say that the Bale pound of the My wife's dowry 625 

, J , „ AI , ^ XT inheritances 3,144 1 6 

epoch was worth 12 Bale batzen. Mow, a Boarders 3 4,626 1 4 

batzen possessed, at the time, the monetary The sale of divers objects. 3,254 17 4 

value of twelve cents, therefore the Bale ProdurtfofmysnKormsk^^."; 90 

pound was worth $1.44. This having been Products of sale of silk- worms' eggs. 2 10 

explained, let us examine Platter's total in- £ aIe ?/. tw ° ? anaries ; ; ■ • • ■ 7 15 

r rr r j . T . lotar m Bale pounds at 12 per batze 

come lor nlty-lour years, and up to within pound 120,020 15 o 

two years prior to his demise. 

An estate of £120,020 was a formidable took the bonnet of doctor in that city at 

one for the epoch, as the purchasing value the age of twenty years, according to De- 

of money in those days was probably at zimeris, twenty-one according to Bridel. 

least five times greater than at present. I accept the latter age as more probable. 

Felix Platter was born at Bale in 1536, After a stay at the then famous University 

studied medicine in his native town, and of Montpellier, Platter traveled in France 

1 Communication made to the Medical Society of Geneva, 3 The item "boarders" refers to sums received from stu- 
May 7, 1910. dents or young physicians who resided with the professor, as 

2 Privat-docent of the History of Medicine at the Univer- was customary in those days. 

sity of Geneva; Vice-President of the Section of the History * In United States money Platter's estate represented the 

of Medicine of the Royal Society of Medicine of London, no mean sum of $172,828.00, an amount that few American 

etc. physicians can hoast of at the end of their careers. 

265 



266 



Annals of Medical History 



and Germany and returned to Bale in 
1560. 

He became professor of medicine at the 
Bale University and a salaried physician 
to the city of Bale (archiates), positions 
that he fulfilled with honor and eclat for 
half a century. 

His reputation became world-wide, and 
drew a large number of students to the 
University of Bale, Platter alone having 
created one hundred and sixty doctors. He 
was consulted by people of many coun- 
tries, and he declined many brilliant offers 
at the German courts, preferring to re- 
main in his native city. However, by cor- 
respondence, which was both extensive and 



very lucrative, he became by his letters of 
consultation, physician to several princes 
of the houses of Saxony, Brandenburg, 
Lorraine, and Wurtemburg, also of Cath- 
erine, sister of Henry IV of France. 

He was most useful to Bale during the 
fearful epidemics of the plague which rav- 
ished the city in 1564 and 1610. He found- 
ed a museum of natural history, as well as 
the botanical garden of the university. 

Honored by foreigners and highly respect- 
ed by his fellow citizens, beloved by the 
poor, he succumbed in a dropsical state on 
July 28, 1 614, at the age of seventy-eight 
years, Platter was six times rector of the 
University of Bale. 



DR. ROBERT LEVET 



Robert Levett, or Levet (17017-1782) 
was "an obscure practiser in physic amongst 
the lower people." Boswell says, "such 
was Johnson's predilection for him, and 
fanciful estimation of his moderate abilities, 
that I have heard him say he should not be 
satisfied, though attended by all the College 
of Physicians, unless he had Mr. Levett 
with him." Levett is said to have picked up 



his small knowledge of surgery while serving 
as a waiter in a cafe in Paris, much fre- 
quented by some French surgeons, who 
became interested in their English servitor 
and gave him the opportunity of learning 
something of their art. He was a hard 
drinking man and seems to have made a 
most disagreeable impression on all who 
met him save the lexicographer. 



WILLIAM PAUL CRILLON BARTON, SURGEON UNITED STATES 
NAVY, A PIONEER IN AMERICAN NAVAL MEDICINE 1 

(i 786-1 856) 
By FRANK LESTER PLEADWELL, M.D. 2 



w 



NEWPORT, R. I. 



HEN it was suggested as 
appropriate that the 
United States Navy- 
should be represented in 
the list of authors contributing articles 
to the Anniversary Volume in honor of 
Sir William Osier's seventieth birthday, 
and I was requested to furnish the article, 
I immediately cast about for a suit- 
able subject. There came to mind a small 
volume, discovered some years ago in an 
obscure corner of the library of the Naval 
Medical School, remarkably advanced in its 
thought for the times, entitled "A Treatise 
containing a Plan for the Internal Organi- 
zation and Government of Marine Hospitals 
in the United States together with Observa- 
tions on Military and Flying Hospitals and 
a Scheme for Amending and Systematizing 
the Medical Department of the Navy" by 
William P. C. Barton, M.D., Surgeon in the 
Navy of the United States. This was the 
second edition, published in Philadelphia in 
1817. 

It occurred to me, therefore, that a 
biographical study of the author of this 
volume might prove of historical interest 
in revealing the state of naval medicine at 
that early period in our service. There 
have appeared several excellent biographical 
sketches 3 of naval medical officers distin- 
guished for bravery in action and heroic 
self-sacrifice in the line of duty, but so far 
as my knowledge goes, no one has essayed 

1 Note. An unavoidable delay in receiving this 
paper prevented its inclusion in "Contributions to 
Medical and Biological Research Dedicated to Sir 
William Osier, Bart., M.D., F.R.S." It is published 
in the Annals of Medical History by arrange- 
ment with the author. 

2 Captain, Medical Corps, United States Navy. 



to portray a character like that of Dr. 
Barton, less heroic perhaps, but one whose 
influence in the direction of medical reform 
and sanitary improvement in the early 
Navy was unquestioned. His book first ap- 
peared in 1 8 14 and the mere fact of its hav- 
ing achieved a second edition three years 
later, is an indication of the estimation in 
which it was held. It contained a fund of 
information collected from various sources, 
both at home and abroad, and revealed an 
originality of thought and an independence 
of expression which stamped its author as 
far in advance of the times. A similar work 
by Dr. Edward Cutbush of the Navy had 
appeared in 1808, but this dealt with sub- 
jects in army administration as well as 
naval, and lacked the breadth and original- 
ity of view characteristic of Barton's book. 

In the following biographical sketch I 
have endeavored to present the outstanding 
facts of Dr. Barton's career in the Navy, 
and particularly to reveal his work as a pi- 
oneer in the field of American naval medi- 
cine. 

William Paul Crillon Barton was born in 
Philadelphia, November 17, 1786. He was 
the son of William Barton, Esq., member of 
the bar, and grandson of the Rev. Thomas 

3 The following are noteworthy examples : 
(1.) Gatewood, J. D., "The Private Journal of 
James Markham Ambler, M.D., Passed Assistant 
Surgeon, United States Navy, and Medical Officer of 
the Arctic Exploring Steamer 'Jeannette.' " U. States 
Nav. M. Bull, Apr. 191 7. 

(2.) Gatewood, J. D., "William Longshaw, Jr., As- 
sistant Surgeon, United States Navy, 1 839-1 865." 
A Biographical Sketch. U. States Nav. M. Bull., Oct. 

I9I3- 

(3.) Elder, William, "Biography of Elisha Kent 
Kane." Philadelphia: Childs and Peterson, 1858. 



267 



2 68 



Annals of Medical History 



Barton, an Episcopal clergyman, who came 
to America from Ireland, in 1751* under the 
patronage of the Penn family. The Barton 
family was of English descent, originally 
from Lancashire, but having obtained ex- 



tenhouse, the daughter of a neighboring 
farmer and a sister of David Rittenhouse, 
the distinguished mathematician and as- 
tronomer, whose close friendship Barton en- 
joyed until his death. He accompanied the 




William Paul Crillon Barton, a pioneer in American naval medicine. 



tensive grants of land in Ireland, settled 
there during the Commonwealth, or early 
in the reign of Charles II. The emigration of 
Thomas Barton took place when he was 
twenty-one, soon after his graduation from 
Trinity College, Dublin. He first opened a 
school at Norristown, Pennsylvania, but 
later became a tutor at the Philadelphia 
Academy. In 1753 ^ e married Esther Rit- 



expedition against Fort Duquesne in 1758 
in the capacity of chaplain, and published a 
sermon dealing with the disastrous incidents 
of that affair. In 1759 he moved from York 
County to Lancaster, where as rector of St. 
James' he remained for nearly twenty years, 
dividing his time between the duties of his 
office and the pursuit of natural history. 
Notwithstanding his friendship with Wash- 



William Paul Crillon Barton 



269 



ington and other distinguished officers of 
the Revolution, he remained a Royalist and, 
declining to take the oath of allegiance to 
the new cause, was compelled to leave his 
post, going to New York. From that city he 
intended to proceed to England, but illness 



delphia merchant, and of their marriage 
several children were born, two of whom be- 
came distinguished surgeons, one the sub- 
ject of this paper and the other John Rhea 
Barton, whose name is perpetuated as the 
originator of "Barton's bandage." 






C , <6K^W^ " ^7$6p> 



^ 







Inscription on the fly-leaf of the "Sick Reports" of the "United States" in Barton's handwriting. 



prevented and he died there on May 25, 
1780. His widow returned to Philadelphia, 
making her home with her nephew, Dr. 
Samuel Bard, at one time physician to 
Washington. 

William Barton, the eldest of Thomas 
Barton's eight children, and the father of 
William P. C. Barton, was a lawyer by pro- 
fession, a gentleman of substantial literary 
attainments, the author of the "Memoirs of 
Dr. David Rittenhouse," and the designer 
of the United States seal. He married Eliza- 
beth, the daughter of John Rhea, a Phila- 



Another distinguished son was Dr. Ben- 
jamin Smith Barton, professor of botany 
at the University of Pennsylvania, and also, 
in later years, the successor to Dr.Benjamin 
Rush as professor of the theory and prac- 
tice of medicine in the University. 

Thomas Pennant Barton, a son of Ben- 
jamin Smith Barton, was also a man of cul- 
tivated literary tastes and achievements. It 
is noteworthy that he gathered together one 
of the best collections of Shakespeareana in 
America. These, together with some ten 
thousand miscellaneous books of his library, 



270 



Annals of Medical History 




<< / M^/^^ ^ 















>*»* 't*? <*, 



/*££#***-. 



y 









cAf**4**<&' 



■St-- »< f/\£J {&<***' 




V<< 



'Yf, ,,*/,<- *t -. 



M. <X#^~ ■- - 



L^ 



,^ 






<7i 



u ^ 



/^ ^ x<, . , - - - - 



e^v 4<i-t'. 



'■'"'■■ <■* ' "■ v" * V 

y£2 { , ■ * 

_ ..... ^^ • ^„ 







^ 



... f'J&sr/' 

^'S^y fey?***.' 






Jk 



f^t/Jpii.^^ Pil -/^.t- .s,.^dt<:-s--c 



\ *'?-u f 



*■&*&**& 






/ 






f^y/ 









First page of the "Sick Reports" of the U. S. frigate "United States. " Barton was first stationed on this vessel when he entered 

the Navy. 



William Paul Crillon Barton 



271 



were acquired after his death by the Boston 
Public Library, where they are known as 
the Barton Collection. 

From the foregoing it will be seen that the 
subject of this sketch came of a family of 
students, and as a contemporaneous writer 
has stated: "His forebears were eminently 
qualified to infuse into his mind the rudi- 
ments of knowledge and the principles of 
virtue." 

Dr. William P. C. Barton received his 
classical education at Princeton, graduating 
with distinction in 1805. Each member of 
his class assumed the name of some cele- 
brated character, and Barton chose that of 
Count Paul Crillon, whose initials he re- 
tained throughout life. He began a study of 
medicine under the direction of his uncle, 
Dr. Benjamin Smith Barton, and received 
his degree in 1808. His inaugural thesis was 
entitled, "A Dissertation on the Chymical 
Properties and Exhilarating Effects of Ni- 
trous Oxide Gas and its Application to 
Pneumatick Medicine." This was con- 
sidered worthy of publication and for 
many years was accepted as a standard 
treatise on the subject. Soon after gradua- 
tion he made a translation from the Latin 
of Jacobus Gregory's "Dissertation on the 
Influence of a Change of Climate in Curing 
Diseases." 

After practicing medicine in Philadelphia 
for about a year during which time he 
became one of the surgeons to the Pennsyl- 
vania Hospital, he received an appointment 
as surgeon in the Navy, upon the recom- 
mendation of Dr. Benjamin Rush and Dr. 
Philip Syng Physick. He was for several 
years on active duty on the frigate "United 
States " ; on the ' ' Essex " ; at tb e Navy Yard, 
Philadelphia; as surgeon to the Marines at 
Philadelphia; at the Naval Hospital, Phila- 
delphia; on the "Brandywine" ; at the Naval 
Hospital, Norfolk; at the Naval Asylum, 
Philadelphia; as chief of Bureau of Medi- 
cine and Surgery; at the Naval Hospital, 
Pensacola, and as president of the Board 



of Medical Examiners at Philadelphia. He 
distinguished himself by his professional 
skill and his scholarly attainments, and 
particularly by his bold and fearless ad- 
vocacy of necessary reforms in the medical 
department of the Navy and the improve- 
ment of the status of the naval surgeon. 
During his periods of shore duty he was not 
content to pass his time unemployed, but 
devoted himself with marked professional 
ardor to the publication of various works, 
some growing out of his naval experience, 
like that on "Marine Hospitals" mentioned 
above, and one entitled "Hints for Naval 
Officers Cruising in the West Indies," 
written in 1830, and others mainly on 
botany. In 18 15 he was chosen professor 
of botany in the University of Pennsylvania 
succeeding his uncle, and in later years he 
was connected with Jefferson Medical Col- 
lege in a similar capacity. He was also a 
fellow of the College of Physicians, a mem- 
ber of the American Philosophical Society, 
president of the Linnsean Society, an honor- 
ary member and surgeon of the First 
City Troop, and upon the creation of the 
Bureau of Medicine and Surgery in the 
Navy Department, Dr. Barton was ten- 
dered and accepted the appointment of 
chief of this bureau. He was, therefore, 
the first chief of bureau, though not the 
first surgeon general of the Navy. This 
title was not created until 1869, and was 
first held by William Maxwell Wood. In 
fact Barton was much opposed to the 
adoption of the title surgeon general; and 
in 1838, when legislation designed to create 
it was pending before Congress, he ad- 
dressed a pamphlet to the members of the 
committees on naval affairs of the Senate 
and the House of Representatives, entitled 
"A Polemical Remonstrance against the 
Project of Creating the New Office of 
Surgeon General in the Navy of the United 
States." This publication reveals that he 
was also a corresponding member of the 
Imperial and Royal Academy of Agricul- 



272 



Annals oj Medical History 



ture of Florence; a member of the Linnsean 
Society of Stockholm and a lecturer on 
materia medica, botany, toxicology and 
naval therapeutics in the Therapeutic Insti- 
tute of Philadelphia. 

While chief of bureau he introduced 
many reforms, corrected numerous abuses 
and received for his services the warm 
recommendation and approval of the then 
Secretary of the Navy, the Hon. Abel P. 
Upshur. His attempts to improve con- 
ditions in the Medical Department, how- 
ever, met with opposition and rendered 
him very unpopular with those whose 
interests or hopes were endangered by his 
efforts. He was not deterred, however, and 
in spite of resistance accomplished much 
in the direction of improvement of condi- 
tions in the Navy, both medical and non- 
medical in character. On March 20, 1844, 
after holding this office for eighteen months, 
he addressed a letter of resignation to the 
President praying for approval of his 
"earnest wish ... to retire from the 
scene of unavailing efforts." He retained his 
naval commission, however, doing duty at 
Pensacola Hospital, but chiefly on the 
Medical Examining Board at Philadelphia, 
and at the time of his death in 1 856, he had 
been for many years the senior surgeon in 
the Navy. 

In September, 18 14, Dr. Barton married 
Esther, daughter of Jonathan Dickinson 
Sergeant, Esq. (a member of the Phila- 
delphia bar), and a granddaughter of Dr. 
David Rittenhouse. 

Of his character, appearance, and per- 
sonal attributes, I have been fortunate in 
securing a reflection from several sources. 
The portrait which appears on the second page 
of this article was taken from what appears 
to be an enlarged photograph now hanging 
in the office of the Surgeon General of the 
Navy. This came from the Naval Medical 
School some years ago, but I have not been 
able to determine anything of its prior 
history. It is said by one of his descendants 



to whom the reproduction was shown to be 
a good likeness and represents his peculiar 
manner of dress, which even for the times 
was considered somewhat elaborate and 
eccentric. It is supposed to represent him 
as he looked about the time he was ap- 
pointed chief of bureau. In a speech de- 
livered in the House of Representatives, 
early in 1844, by the Hon. Alexander H. H. 
Stuart of Virginia, Barton was referred to, 
in connection with an investigation into the 
expenditures of the newly created Bureau 
of Medicine and Surgery, in terms which 
give us an idea of the impression made 
upon a contemporary by his manner and 
style of composition. Mr. Stuart stated: 

"I, like others, have been somewhat 
prejudiced by the artificial and involved 
style of his report submitted to the House; 
a prejudice by no means diminished by 
his manner and style of dress, equally 
unnatural and eccentric. But when I 
knew him better and heard and saw the 
improvements which he had introduced 
into the Bureau, my prejudice vanished 
and I became satisfied he was a most 
capable and faithful officer." 

The same speaker refers later to his 
"bold and manly spirit of independence, 
which induces him to shrink from no 
responsibility." 

In the findings of his court-martial in 
1 818, a reference was made by the court to 
"the vehemence of his manner (which) 
imparted impressions his language and 
intentions would not warrant." 

One of the most valuable comments on 
his manner and personal qualities appears in 
an address delivered before the Alumni As- 
sociation of the Jefferson Medical College, 
on March 11, 1 871, by Dr. Samuel D. Gross, 
professor of surgery in the college and 
president of the association. He refers to 
Dr. Barton in these terms : 

"The instruction in materia medica, 
during the two Winters of my connection 



William Paul Crillon Barton 



273 



with the College, was delivered by Dr. 
William P. C. Barton, brother of Dr. 
John Rhea Barton, the eminent surgeon, 
and a nephew of Dr. Benjamin Smith 
Barton, formerly a professor in the Uni- 
versity of Pennsylvania. He was, in all re- 
spects, a remarkable man: highly edu- 
cated, learned in his profession, a graceful 
lecturer, an able writer and one of the 
most accomplished botanists in America. 
He abounded in flashes of wit; and a vein 
of irony and sarcasm was perceptible in 
almost everything he did and said. He had 
a passionate love of music and played 
with consummate ability upon the flute 
and violin. Many of his acts were marked 
by the eccentricities of genius. His style 
of lecturing was conversational, plain, 
simple and didactic, without any attempt 
at oratory, and his success as a teacher 
was all that could have been desired. In 
his appearance he was a model of neatness 
and elegance. He seldom wore the same 
coat, vest, or cravat on two successive 
days. In his criticisms of contemporane- 
ous writers he was often severe and even 
bitter, especially when he had occasion to 
speak of a certain writer on materia 
medica, with whom he had long been on 
terms of open hostility. He would then, 
often with a peculiarly disdainful curl of 
the upper lip, fly off into the keenest 
satire and invective, much to the amuse- 
ment of his young auditors, all of whom, 
with few exceptions, were warmly at- 
tached to him. It was his invariable prac- 
tice, too much neglected in most of our 
schools, every morning to ask the class 
some questions respecting the lecture of 
the previous day." 

"During my first Summer in Phila- 
delphia I was a member of Dr. Barton's 
botanical class, and usually attended him 
in his botanical excursions along the 
banks of the Schuylkill, visiting Bart- 
ram's Conservatories or rambling about 



in the open field in search of specimens. 
In these excursions he was always in his 
happiest mood, skipping merrily, like a 
humming-bird, from flower to flower. He 
experienced as great delight in the dis- 
covery of a new plant as Audubon did at 
the sight of an undescribed bird, or John 
Hunter in the dissection of a strange 
animal. He was in fact a botanical 
enthusiast." 

In attempting to find Dr. Barton's grave 
in Laurel Hill Cemetery, Philadelphia, I was 
fortunate in getting in touch with one of his 
lineal descendants. This gentleman I met 
later and obtained from him much addi- 
tional information, of a character which 
could not have been secured elsewhere. 

Through his kindness I have been able to 
read a biographical sketch of Dr. Barton 
which was compiled in 1879 by one of Dr. 
Barton's daughters. In this she refers to her 
father as possessing "many personal at- 
tractions and accomplishments. He retained, 
even to advanced years, a great love for 
music and great conversational powers. His 
character was a happy combination of quali- 
ties which attracted all and repelled none. 
Of great courage without any bravado, of 
affability without servility, of true warm- 
hearted benevolence, his qualities of heart 
and of mind were well calculated to secure 
lasting friends among the good and true." 

I also learned from him that Barton had 
assembled in his lifetime a very remarkable 
collection of musical instruments, which he 
recalls seeing as a child in the home on 
Chestnut Street. It was here that Barton 
lived and had his office. The house is still 
standing, but in reconstruction it has been 
joined to another, which has been built over 
part of the plot, formerly the garden of the 
Barton home. 

The facts recorded regarding Dr. Barton's 
career in the service were found to be few 
and meagre, particularly with reference to 
his service at sea, and the chief and most 



274 



Annals oj Medical History 



valuable sources of information regarding 
him were found in "Officers' Letters," scat- 
tered throughout many volumes, covering 
the years 1809 to 1848, which are filed in 
the Navy Department Library. These, to- 
gether with allusions made in his writings 
to various incidents of his life and work, 
have constituted the main sources from 
which the facts of this sketch have been 
drawn. 

The records of the Navy Department 
show that Dr. Barton was appointed a sur- 
geon on April 10, 1809, to take rank from 
June 28. His letter of appointment also con- 
tained orders to the frigate "United States." 
In a letter which was written from the 
Pennsylvania Hospital, and addressed to 
the Hon. Charles M. Goldsborough, 
Esq., secretary of the Navy, he accepted 
his appointment and requested a delay of 
six weeks before joining the "United 
States," explaining that the delay was 
necessary to enable him to complete his 
term of service at the hospital, which ran to 
July first. It is apparent from this letter that 
he felt a deep sense of obligation to fulfil 
what he considered an implied contract with 
the hospital authorities to remain until his 
period of service was completed, but his re- 
quest was denied, for the "Sick Reports" of 
the "United States," show that he was al- 
ready aboard that vessel on June 7, 1809. 
On June 10, 1809, Stephen Decatur, Jr., had 
joined the "United States" and hoisted his 
broad pennant as commodore for the first 
time, and then began the friendship with 
Decatur which lasted throughout life. Very 
little has been found respecting Barton's 
service on this vessel, which apparently 
continued only until about November 10, 
1 810, for soon after that date he is found 
on the "Essex." 

Practically no medical records relating to 
the ships of this period are to be found in the 
Navy Department, but, by a mere chance, 
two thin volumes of the "Sick Reports" of 
the "United States," in Barton's own hand- 



writing were found in the Library of the 
Naval Medical School, where they had been 
placed in 1905 by former Surgeon General 
Rixey, who had discovered them in a second- 
hand bookstore in New York. 

In the early days of the Navy, although 
the regulations required the commander 
of a vessel to keep an official log, the gov- 
ernment did not furnish the log book. It 
happened therefore that a book purchased 
by an officer for this purpose, was often 
regarded as personal property, and taken 
away by him when detached from the ship. 
It is not improbable that a similar custom 
existed with respect to medical records. 
This condition of affairs may account for 
the absence of medical records covering this 
period and also for the fortuitous discovery 
at this late day of the "Sick Reports" 
of the "United States." These reports 
ran from June 7, 1809, to November 10, 
1 810, and were entered in Barton's hand- 
writing in two small note books. A repro- 
duction of the first two pages, showing the 
opening entries, appears in the text of this 
article. As one scans the pages of these 
small books it is surprising to note how 
sparse is the information to be obtained 
regarding the movement of disease or 
important daily events. Only one entry is 
made giving the location of the ship, that 
occurring on the second page, where it is 
noted as "Crany Island, Elizabeth River, 
Vir." Unfortunately, no record of the other 
ports or places visited is found. The usual 
day's record shows the name of the disease, 
complaint or injury, rarely in a scientific 
nomenclature, which is set opposite the 
name of the patient, and an entry is made 
of admissions and discharges for the day. 
The progress of a patient is sometimes 
stated in a word or two, such as "im- 
proving," "better," or "worse," too often 
the latter, and deaths are not infrequent. 
The prevalence of "typhus fever" is note- 
worthy and by this, of course, is meant the 
typhoid fever of later days, although the 



William Paul Crillon Barton 



275 



occasional sudden demise of a patient with 
"typhus fever" suggests typhus exanthema- 
ticus. In those days, as now, itch and ven- 
ereal diseases occupied a conspicuous posi- 
tion in the sick returns, and the occasional 
appearance of midshipmen with the latter 
class of disease, with the added remarks, 
"reported to the commodore as rheuma- 
tism," denoted a kindly intention on the 
part of the surgeon to shield them from 
the stigma attaching to these affections. 

On July 15, 1810, for the first time, Dr. 
Barton makes extended "Remarks," at the 
end of the day's record, as follows: "The 
dysentery and diarrhoea are now and have 
been for the last ten days the prevailing 
diseases on board the ship. Most of the 
patients on the sick list with other diseases 
are more or less afflicted with these com- 
plaints in a slight degree. Neither of these 
diseases, however, are of a very violent 
nature." This constitutes the only clinical 
observation of any moment which I could 
discover in a review of the seventeen 
months' record contained in these reports. 
It is also quite remarkable how seldom 
mention is made of the transfer of patients 
to hospital. However, considering the cha- 
racter of the so-called hospitals then avail- 
able, it is perhaps not surprising that he 
preferred to retain the sick aboard ship. 
Later in his career he urged improvement 
of naval hospitals with characteristic vigor, 
and a critical reference in his book on 
"Marine Hospitals", published in 1814, 
with respect to the hospital at the Navy 
Yard, Philadelphia, was the basis of charges, 
made by a brother medical officer, which 
resulted in the court-martial of Barton. 
The court, however, perhaps realizing the 
justice of his criticism, ruled that the speci- 
fication covering the alleged offense need 
not be answered or refuted, and thus vir- 
tually exonerated Barton of this specifica- 
tion of the charge. Some of the entries in 
the "Sick Reports" are very obscure in their 
clinical and pathological significance. For 



instance, while there can be little question 
regarding the nature of the disease entered 
as "typhus," which caused the death of Wm. 
Rysela on July 6, 1809, since Barton has 
added "sick two months," what did James 
Williams, 1st, really succumb to on August 
17, 1809, under the designation "nervous 
fever," when on the previous day he first 
appears as "very ill, typhus?" 

Barton mentions in his work on hospitals 
that he checked several cases of sea-scurvy 
on the "United States" by the liberal 
administration of lime juice. He had much 
to say later, after his cruise abroad in the 
"Essex," of its virtues as an anti-scorbutic, 
and urged its adoption by our Navy, in an 
official report. 

In the preface to the first edition of his 
work on "Marine Hospitals," Dr. Barton 
refers to his attempts to bring about cor- 
rection of the abuses and irregularities then 
prevailing in the medical department, by 
reason of what he terms "loose administra- 
tion." As his statement there fully reflects 
his attitude toward the problems confront- 
ing him on the frigate "United States," 
and his grave concern for the welfare of the 
sick, and the improvement of medical sup- 
plies, I cannot do better than quote it at 
length : 

"Having entered the navy as a surgeon 
when very young, and having been 
ordered to one of the largest ships in it, 
with a complement of 430 men, stationed 
in a warm and variable climate — I soon 
found myself not a little embarrassed by 
the perplexities that I daily met with in 
my practice on board. The unhealthiness 
of the climate, operating upon a variety 
of different constitutions in an entirely 
new crew; the change of diet and mode of 
life; the necessary and unavoidable ex- 
posure of boats' crews to the fervid rays 
of a vertical sun, as well as to the damp 
and heavy dews of night, and at all times 
to the insalubrious exhalations of marsh 



276 



Annals oj Medical History 



miasma — all combined to generate such 
perpetual sickness, that the frigate might 
almost have been called a hospital ship, 
the average number on the daily sick- 
list, of fevers and fluxes, being about 40. 
In this situation, on board of a ship just 
refitted, commissioned, and equipped, I 
found myself without half the comforts 
and necessaries for the sick that the 
hospital department should have been 
supplied with; yet this department had 
been reported as replenished with every 
requisite article for a cruise of two years, 
and together with the medicine chest, had 
cost the government fifteen hundred 
dollars. There were neither beds for the 
sick, sheets, pillows, pillow-cases, nor 
nightcaps — nor was there a sufficiency of 
wine, brandy, chocolate, or sugar; and 
that portion which the storeroom con- 
tained of these articles, was neither pure 
nor fit for sick men. The medicine chest 
was overloaded with the useful, and 
choked up with many useless and dam- 
aged articles. Such was the state of the 
medical department of this ship! Upon a 
representation of it however to her com- 
mander, Com. Decatur, he generously 
allowed me all the necessaries I stood in 
need of, and thus enabled me to ad- 
minister those comforts to my patients, 
which they so much required. What 
would have been my situation, had the 
ship immediately proceeded to sea, for 
a cruise of eight or ten months, upon my 
joining her, and before I had an oppor- 
tunity of examining into the condition of 
the medicine and store chests ... 
which might have been the case, these 
having been reported as sufficiently fur- 
nished? What the consequence would 
have been must be obvious! The other 
ships were not better furnished than the 
one of which I am speaking — and I per- 
petually heard of complaints on this score. 
"What was the cause of these abuses? 
The want of a regular board of medical 



Commissioners, whose peculiar province 
it should be, to order the proper propor- 
tions and quantities of medicine, com- 
forts, and necessaries, for the publick 
ships, and who should have no interest, 
directly or indirectly, individually or col- 
lectively — in the furnishing of articles 
thus ordered. 

"As I was at that time a perfect novice 
in the routine of ship duty, and having 
then but recently left the Pennsylvania 
Hospital, an institution in which order, 
system, and punctuality, render the prac- 
tice of medicine a pleasure, I was over- 
whelmed with the difficulties I had to en- 
counter in the performance of professional 
duties, where every species of inconveni- 
ence and disadvantage that can be imag- 
ined was opposed to the exertions of the 
surgeon. My feelings revolted from the 
idea of continuing in such a perplexing 
and distressing situation — and I became 
disgusted with the unavailing toil attend- 
ant upon ship-practice. I communicated 
my sentiments on this subject unre- 
servedly to my lamented friend, the late 
captain Wm. Henry Allen, then first 
lieutenant of the ship. I ventured even at 
that early period of my naval service, to 
condemn the flagrant irregularities and 
abuses, that I could not but believe ex- 
isted to a ruinous extent. In my conversa- 
tions with him I often declared, that if 
such was always the deplorable condition 
of sick men on shipboard, I wished not 
longer to be their medical attendant; for 
my feelings were every moment in the day 
subjected to harassment and pain, from 
contemplating afflictions I was unable to 
relieve, for the mere want of comforts so 
easily procured on shore. He encouraged 
me, however, to persevere, and at the 
same time that he lamented with me the 
want of a superintending medical board, 
he tendered an offer of his assistance in 
making any arrangements compatible 
with the internal economy of the ship, 



William Paul Crillon Barton 



277 



that I might deem calculated to meliorate 
the condition of the sick. I soon found 
that their situation was susceptible of 
much relief, even on ship-board — and I 
was not long concluding, that if proper 
steps were taken to furnish the ships with 
sick-necessaries of a proper kind, the 
practice of medicine and surgery in the 
navy could be rendered not only more 
beneficial to the sick, but less offensive to 
the humane feelings of the medical officer. 
I never lost sight of the opinion I had 
conceived, that the errors of the medical 
department of the navy might be easily 
corrected, and its abuses abolished." 

Surgeon Barton's relations with Com- 
modore Decatur and with the first lieuten- 
ant of the "United States," William Henry 
Allen, 4 appeared to have been most cordial 
and harmonious. This is evidenced by the 
fact that Decatur, in 1813, applied to the 
Secretary of the Navy for Barton to be re- 
turned to the "United States," and in 1817 
he gave him a strong letter of recommenda- 
tion to the then Secretary of the Navy, and 
both he and Captain David Porter of the 
"Essex" came to his aid in support of many 
of the reforms he had projected. Decatur in 
the letter of recommendation above-men- 
tioned testified "to the great skill and atten- 
tion and success with which he (Barton) 
practised during the above period." (1809- 
1810) Late in 1810, however, Barton ap- 
pears to have had some disagreement with 
certain officers on the "United States," the 
nature of which is not revealed, but the re- 
sulting situation made it expedient for him 
to leave the ship. About this time the "Es- 
sex," was preparing to sail for Europe, and 
since her surgeon, Dr. Stark, was on leave 
at some distant point inland and could not 

4 This is the same Captain Allen who commanded 
the "Argus" in her encounter with the British Brig 
"Pelican," August 14, 1813. The "Argus" had sunk 
twenty-two vessels off the British coast, but was 
defeated and captured by the "Pelican." Allen 
died of his wounds at Mill-Prison Hospital, Ply- 
mouth, England. 



return in time to reach the ship before sail- 
ing, with Decatur's approval, and as a con- 
venience to Capt. Smith of the "Essex," 
Barton left the "United States" and joined 
the "Essex." It was during this cruise that 
he gathered much of the information regard- 
ing naval hospitals, and naval medical prac- 
tice abroad, both in the navies of Great 
Britain and France, which appeared later in 
his writings. His observations covered a 
wide range of subjects, including the con- 
struction and arrangement of all the prin- 
cipal naval hospitals of England and France, 
their organization and administration; sani- 
tary matters touching the naval services; 
methods of training medical officers; ra- 
tions; character of supplies furnished ships, 
their construction, etc. He appears to have 
visited London from Cowes, Isle of Wight, 
where the ship was lying, and, while there, 
to have met the celebrated Dr. Lettsom 
through an introduction from Dr. Rush, and 
to have inspected several hospitals. He men- 
tions the homeward bound voyage of the 
"Essex," which lasted two months, and 
speaks of the efficacy of an effervescing mix- 
ture of lime juice and salt of tartar for sea- 
sickness. This he administered to two pas- 
sengers on board with great success. Other 
than the above, surprisingly few details of 
this period of his career were" to be found in 
available material. 

On June 30, 181 1, he addressed a letter to 
the Hon. Paul Hamilton, Secretary of the 
Navy, requesting relief from sea duty and 
assignment to the Navy Yard, Philadelphia. 
He mentioned that he had been on sea ser- 
vice without any intermission since April, 
1809, and had just returned on the "Essex." 
He asserted his willingness to act in concert 
with, or subordination to, Dr. Cutbush, the 
surgeon in charge at Philadelphia, and al- 
though a surgeon himself, was agreeable to 
service in a position, which ordinarily would 
be assigned to a surgeon's mate. His extreme 
anxiety to return to Philadelphia apparently 
arose from a desire to establish himself in 



278 



Amials oj Medical History 



practice there, "the accomplishment of 
which is his dearest wish," to supplement 
his income, and help support his aged father 
and seven brothers and sisters. This he de- 
sired to do, moreover, while his uncle (Ben- 
jamin Smith Barton), who was in a precari- 
ous state of health, was still able to take him 
by the hand and introduce him into practice. 
He refers to his uncle as a man "the tenure 
of whose existence is fragile indeed . . . thus 
there is the brightest prospect of my pro- 
fessional success subject to the constant 
shadow of a very near cloud." His family is 
constantly in mind, and as the eldest son, 
his concern for their welfare is often re- 
flected in his letters. The pay of a surgeon 
at this time, including the value of two ra- 
tions, was sixty-two dollars per month, a 
sum wholly inadequate to the value of the 
service performed, and of course, not suffi- 
cient to enable him to contribute materially 
to the support of his family. He speaks 
further of the difficulty aboard ship of keep- 
ing himself abreast the times professionally. 
"The unsettled and wandering life on board 
ship not only deters the gratification of pro- 
fessional ambition, but absolutely generates 
an inanition of mind very inimical to solid 
improvement of any kind. The sea does not 
subject me to any corporeal malady, but 
really produces a spiritless inaction and 
mental debility which all the resolution I 
have been able to exert for better than two 
years has not afforded me the power to 
overcome." His appeal, however, appears to 
have fallen on deaf ears, for he was not de- 
tached from the "Essex," but did manage to 
get leave until September ist. A letter dated 
July ii, 1811, written from Baltimore, ad- 
dressed to the Secretary of the Navy, refers to 
a bottle of lime juice which he is sending him 
by Lieut. Ballard for trial "in the form of a 
lemonade, after allowing it to settle for a 
day or two." This is one of four dozen bottles 
which Barton brought back from England 
and he explains that his object in sending 
the lime juice is to enable the Secretary to 



judge of the quality of juice used in the 
Royal Navy, which is the kind he wishes to 
recommend for our own. He also mentions 
his intention to submit a report on this sub- 
ject. This letter indicates that he had been 
in Washington, and was on his way to Lan- 
caster, but had been delayed in Balti- 
more on account of an attack of "summer 
complaint." On August 26, 181 1, writing 
from Lancaster he requests two months' ex- 
tension of leave, and to be assigned to duty 
at the Navy Yard, Philadelphia. In this 
letter he makes the first reference to his in- 
tention of writing at length upon his obser- 
vations abroad and upon a plan for the better 
government of the Medical Department of 
the Navy, and puts this intention forth as a 
reason for the change of duty requested. He 
also states his desire to take courses of 
study in the Pennsylvania Hospital. A 
reference is made in this letter to Mr. 
Latrobe, 5 whom he has asked to see the 
Secretary and support his request. But it is 
all to no avail, for a peremptory order from 
the Secretary, dated August 29th, is sent to 
him to return as soon as possible to his ship 
the "Essex," at Norfolk. Barton answered 
this letter from Lancaster on September 
4th, and voiced his disappointment at not 
being accorded the leisure to complete his 
report, but states his intention of doing so 
at Norfolk. This letter reveals grave dis- 
content at being continued on duty in the 
"Essex," a vessel "smaller than the one he 
first joined when he entered the service," 
where "his services gave the greatest satis- 
faction to Commodore Decatur and the 
officers generally." As respects the latter, 
with some of whom he had been in disagree- 
ment, he states that there has been a recon- 
ciliation and he desires his transfer from 
the smallest frigate in the Navy, back to the 

5 Benjamin Henry Latrobe, 1764- 1820. An English 
architect who settled in this country in 1796. He 
became identified with the Navy Department as an 
engineer, and designed the first Hall of Representa- 
tives at Washington. 



William Paul Crillon Barton 



279 



"United States." He endeavors to reinforce 
his argument by adding that, "the present 
surgeon of the 'United States' was a surgeon 
of a cutter at the time I was in the station he 
now occupies." It is not unlikely that he 
received still another order from the Secre- 
tary to expedite his return to the "Essex," 
for Barton wrote from Philadelphia Septem- 
ber 18, 181 1, explaining the delay in his 
journey to Norfolk, as being due to a con- 
tinuance of the affection which overtook 
him at Baltimore two months previously, 
and that he has written Captain Porter of 
the "Essex" to that effect. He encloses a 
physician's certificate in support of his 
statement. 

A letter written October 25, 181 1, from 
Norfolk, transmits to the Hon. Paul Hamil- 
ton, secretary of the Navy, a number of 
sheets containing a plan for the internal ar- 
rangement of marine hospitals. This evi- 
dently is a further development of his 
proposed report, which finally grew into the 
book he published in 18 14. The term "ma- 
rine" hospital as used frequently by him was 
equivalent to the naval hospital of the pres- 
ent day. At that early period a distinction 
such as prevails at present did not exist. 
There were, it is true, "Marine" hospitals 
for merchant seamen, available to the Navy, 
which became separated from the Navy by 
the Act of Feb. 26, 181 1. 

On November 2, 181 1, Dr. Barton is back 
in Philadelphia, on leave, in order to attend 
the funeral of a brother. He appears to have 
travelled by water from Norfolk to New 
York, on this occasion, in the U. S.S. "Hor- 
net," then under command of Captain James 
Lawrence, thence by stage to Philadelphia, 
leaving Norfolk October 26, and arriving in 
Philadelphia November 2, which for the 
times was quite rapid travelling. In the 
preface to his 1814 publication he refers to 
the trip on the "Hornet" and to his visit to 
Washington in July, 181 1, when Mr. Hamil- 
ton called upon him to submit his ideas re- 
specting the proper rules for administration 



of the service hospitals, which the Secretary 
was required to submit to Congress at its 
next session. The Act of February 26, 181 1, 
had separated the navy from the conjoint 
control of marine hospitals for merchant 
seamen and had authorized the establish- 
ment of distinct institutions for the navy, 
but nothing was done until 1832 toward 
furnishing these hospitals, except to rent 
temporary structures near the principal 
navy yards. From that date naval hospitals 
slowly arose at the principal stations. It was 
this report containing suggestions for the 
internal organization and government of 
hospitals, requested by the Secretary, which 
Barton refers to in the preface of his book, 
as having been written "during a tempestu- 
ous passage from Norfolk to New York, in 
the Hornet sloop of war, with the ever to be 
lamented captain Lawrence, under the dis- 
advantages, too, of sea-sickness and acute 
mental affliction from the recent loss of a 
friend — a brother." 

On November 18, 181 1, Barton writes 
from Lancaster, where he had gone after 
his brother's funeral, renewing his request 
to be ordered back to the "United States," 
stating that his action had the approval of 
Commodore Decatur, and quoting from a 
letter received from Mr. Allen, first lieu- 
tenant, in substantiation of their desire to 
have him. This letter, which is addressed 
to the Secretary, also mentions the intention 
of the writer to leave Lancaster for Phila- 
delphia on November 19th, on his way to 
Norfolk. His failure to return promptly 
to his post of duty called forth peremptory 
orders from the Secretary, dated November 
23, and Barton replied from Philadelphia 
on November 27th, in effect, that he con- 
siders the Secretary's reprimand for not 
obeying orders as entirely unmerited, and 
he enters into a long explanation of the 
circumstances surrounding his transfer from 
the "United States" to the "Essex" in 
November, 1810. His delay at Philadelphia, 
he states, is due to information received 



280 



Annals of Medical History 



from Norfolk that the "Essex" is coming 
up the Delaware, and that he has remained 
there to await her arrival. There is a feeling 
of resentment plainly apparent in this 
letter to the Secretary which may have had 
its origin in the knowledge on the part of 
Barton that the Secretary had recently 
written Dr. Benjamin Smith Barton, his 
uncle, and referred to Barton as "too much 
indulged." 

Still on the "Essex," then at Newport, 
Rhode Island, on December 26, 181 1, Bar- 
ton writes to Mr. Latrobe, who has agreed 
to intercede with the Secretary on his behalf 
in the matter of receiving a twelve months' 
furlough. He repeats his desire to enter into 
practice at Philadelphia, but adduces 
another reason for the furlough, which has 
not hitherto come to light, although it may 
have been a powerful influence, in addition 
to others, in urging him to the repeated 
efforts he has made to secure the desired 
duty. This reason, "very dear to my heart", 
has to do with his engagement to Miss 
Sergeant, who, he mentions, is a grand- 
daughter of Dr. David Rittenhouse, and he 
asks Mr. Latrobe if she is not a connection 
of his. Barton encloses in this letter a com- 
munication from Captain Porter approv- 
ing his request, which he asks Mr. Latrobe 
to present to the Secretary, when he makes 
the plea on his behalf. 

A letter under the same date goes forward 
from Barton to the Secretary requesting the 
furlough of twelve months "in order to get 
married and also to assist in the support and 
education of his youngest brother." He 
suggests a Dr. Miller as his relief on the 
"Essex." But his efforts prove fruitless, for 
Captain Porter receives a letter from Mr. 
Hamilton which amounts to a denial of 
Barton's request. On January 18, 181 2, he 
renews his application but reduces the 
length of the furlough acceptable to him, 
from twelve months to four or five months. 
On the 2 1 st of January, not having had any 
reply to his previous letters he writes he will 



take any length of furlough which will be 
agreeable to the Secretary. On January 2 2d 
he addresses the Secretary again requesting 
the return of the hospital plans forwarded 
October 25, 181 1, and refers to additional 
work which he is doing in connection with 
them. On January 24th, he informs the 
Secretary that his father has requested him 
to resign, but states his unwillingness to do 
so, on account of a promise made to his 
uncle not to leave the service until after he 
has completed his book on Marine Hospitals 
and the Medical Department of the Navy. 
On February 13, 18 12, not having had any 
reply to his letters of the 18th, 21st, and 
24th of January, addressed to the Secretary, 
he sends him duplicates and also encloses a 
copy of Captain Porter's letter. As a possible 
relief for him on the "Essex" he suggests 
Dr. Daniel Hatfield of the "Nautilus". 
The next letter is dated March 8th, 1812, 
and in this he reports himself as ill in sick 
quarters at Newport, Rhode Island, with 
an "affection of the heart," and desires that 
a surgeon's mate be sent to the "Essex," as 
a substitute during his illness, and to relieve 
the surgeon of the "President" of the 
necessity of looking out for the sick on the 
"Essex" which he has done for two months. 
On March 20th, 181 2, Captain David Porter 
of the "Essex" wrote him the following 
letter : 

"It is with much pleasure I acknowl- 
edge the receipt of your highly gratifying 
letter of this date and it is the source of 
the most pleasing sensation to receive 
the testimony of the approbation of one 
whom my duty and inclination both 
prompt me to esteem for his strict atten- 
tion to his profession and for his character 
as a gentleman. I cannot but regret the 
unpleasant circumstance that now ren- 
ders your absence from duty necessary 
and offer you my best wishes for the 
speedy restoration of your health and 
assurances of the extreme pleasure it 



William Paul Crillon Barton 



281 



would afford me to have you again 
attached to my command." 

On March 21st, Commodore John Rod- 
gers on the "President" granted Barton a 
furlough of five weeks for the benefit of his 
health, on the expiration of which he was 
desired to return to the vessel to which he 
was then attached. On April 3, 18 12, Barton 
was ordered to the Navy Yard, Phila- 
delphia, as assistant to Dr. Cutbush, and 
the next letter from him to the Secretary is 
dated at Washington April 4, 1812. In this 
letter he refers to certain "Rules and Reg- 
ulations for the Government of Naval 
Hospitals," which apparently the Secretary 
had submitted to Barton for criticism. He 
addresses his reply through Mr. Golds- 
borough and expresses his unqualified ap- 
proval of the "Rules." His duty at Phila- 
delphia was not long undisturbed, for on 
June 22, 1 81 2, he was ordered to the brig 
"Argus," with an intimation that after 
a short cruise he might expect to return to 
Philadelphia. His reply by letter dated 
June 24th, 1 81 2, complaining of his treat- 
ment since being in the service and pro- 
testing against being assigned to a brig 
after service in a frigate, apparently had 
the desired effect, for there is no evi- 
dence that he went to the "Argus;" on the 
contrary, several letters from Dr. Cutbush 
to the Department during the succeeding 
months make references to Barton in con- 
nection with duties at the Navy Yard or 
vicinity. His official record, however, shows 
that on February 20, 1813, he was ordered 
to the "United States," but these orders 
were revoked for reasons which appear later. 

On January 1, 1813, Lieutenant John B. 
Nicholson, who was with Decatur on the 
"United States," then at New York, had 
written to Barton as follows: 

"The Commodore is in want of a Sur- 
geon and has requested me to write you 
on the subject, and if you will go again 
in this ship in that situation, you will be 



so good as to write me immediately, and 
he will then apply for you to the Depart- 
ment. Although so long silent, believe 
me, I have often thought of the many 
pleasant moments passed in your society, 
and I as well as my mess will be happy 
to call you by the endearing name of 
mess-mate and friend. To Spencer Ser- 
geant will you give my respects, and 
believe me to be your friend." 

What answer Dr. Barton made to this 
letter is not known, but subsequent cor- 
respondence from Decatur to him, makes it 
plain that he declined the appointment. 
On March 11, 1813, Commodore Decatur 
wrote him as follows: 

"Enclosed is a letter which I have 
received from the Navy Department 
with instructions to forward it to you. 
I apprised the Secretary of the reasons 
which you had urged to me, to induce the 
recall of the order you were under for my 
ship. I stated to the Secretary, that if 
they struck his mind with the force they 
had mine, you would be gratified in your 
wishes, and some other gentleman sub- 
stituted. Will you have the goodness to 
let me know your determination on the 
subject as soon as possible. Your friend 
and humble servant. Stephen Decatur." 

The enclosure referred to in this letter was 
in all probability the Secretary's order, 
which reads as follows: 

"Com. Decatur wants a Surgeon, and 
from his confidence in your abilities, he 
has asked that you might be ordered to 
his ship. Anxious as I am to give him a 
Surgeon acceptable to him, I have to 
direct that you will proceed to New York 
and place yourself under his command. 
W. Jones." 

I have given this correspondence at some 
length since Barton's declination to sea 
duty in time of war subjected him to severe 



282 



Annals oj Medical History 



criticism, openly expressed in later years, 
when he was chief of bureau, by his 
enemies, of whom he appeared always to 
have a liberal number, who were active at 
the time in attempting to legislate him out 
of office. In 1843 a proviso was attached to 
the Naval Appropriation Bill which pro- 
vided that any appointee as chief of 
bureau, in order to be eligible, should have 
completed at least five years' service at sea. 
The effect of this, if passed, would have 
been to vacate the offices of two chiefs of 
bureau, of which Barton held one. In 
defense of his position and in answer to the 
criticism that he had refused service in time 
of war, Barton addressed a letter to the 
Hon. George Evans, of the Senate, in which 
he referred to his declination to go to the 
"United States" in the following terms: 

"The only order he received during the 
war, was one to Commodore Decatur's 
ship. That officer was the embodiment 
of honor and heroism, and that officer 
obtained a revocation oj that very order, 
under a full knowledge of all the circum- 
stances of the then employment of the 
undersigned in Army duty, as well as 
Naval duty; and with a knowledge too 
of the state of his health, then improving 
but not reinstated. ... If such a man 
as Decatur saw no wrong in the declina- 
tion of the order to his own ship; if he 
undeviatingly bestowed his respect on 
the undersigned, from the first of his 
acquaintance with him until the day of 
his death, can any other man in the Navy 
be justified in an attempt to impugn the 
reputation of the undersigned on that 
ground?" 

The reference to "Army duty" in this let- 
ter brings to light the fact that in 181 2 and 
1 81 3 while on the Philadelphia station he 
had offered to perform the duties of surgeon 
to the different recruiting rendezvous of 
the Army District. 



The District Orders of February 1, 18 13 
read: 

"His (i.e. Barton's) certificate is neces- 
sary to pass a recruit and no other phy- 
sician is to be called upon to visit and 
pass enlisted soldiers, except in circum- 
stances which will not admit of delay." 

In his work published in 18 14, he refers 
to this service as follows: 

"In the first year of the present war, I 
examined two thousand recruits in the 
city, and from the neighborhood of Phila- 
delphia. Twelve hundred only of this 
number did I pass as able-bodied men; 
and of the rejected number, 800, more 
than two-thirds were refused on account 
of rupture." 

On May 10, 1813, Dr. Cutbush having se- 
cured his own transfer to duty in Washing- 
ton, Dr. Barton made application to suc- 
ceed him at Philadelphia. It does not appear 
that this request was denied, and at any rate 
he appears to have remained near Phila- 
delphia, carrying on his service duties, Army 
and Navy, pursuing his practice, and de- 
livering his lectures as professor of botany 
at the University. In addition he did a pro- 
digious amount of writing, and published 
several books. In a letter to the Secretary 
dated May 25, 1813, he voices his concern at 
the insufficient accommodations for the sick 
at the Navy Yard. He states that the small 
building appropriated to the reception of 
sick, calculated to accommodate eight pa- 
tients, now has twenty-four sick sailors, and 
suggests the necessity of some temporary 
arrangement. Commodore Murray declined 
entering into any measure without instruc- 
tions from the Secretary, but approved of 
Barton's writing to represent the matter 
and, as a result, the Secretary authorized the 
erection of a frame building. It was his 
strictures on the sick quarters at this yard, 
appearing in his book published the next 



William Paul Crillon Barton 



283 



year, which Dr. Harris objected to as re- 
flecting upon Dr. Cutbush and which led to 
Barton's court-martial in 181 8. It is inter- 
esting to note just what Barton said in this 
connection, and to see how far his contem- 
poraries bear him out with respect to the 
standards of sick accommodations available 
in the Navy at that time. He states: 

"I have myself seen among a number of 
sick seamen with whom I was left in 
charge at the navy yard of this place 
(Philadelphia) where they were neces- 
sarily huddled into a miserable house, 
scarce large enough to accommodate the 
eighth part of their number — a spirit of 
impatience. ... So wretched was the 
hovel and so destitute of every necessary 
comfort for sick persons, in charge of 
which I was left with thirty patients . . . 
that every man who gathered sufficient 
strength . . . absconded immediately." 

On March 17, 1820, Commodore John 
Rodgers, then president of the Board of 
Navy Commissioners, addressing the Chair- 
man of Naval Affairs of the Senate, repre- 
sented the inexpediency of blending Navy 
and Marine (merchant) hospitals, in speak- 
ing of the temporary hospitals at Navy 
yards, stated as follows: "Cheerless and 
comfortless as they are, they are yet prefer- 
able to hospitals provided for seamen of the 
merchant marine." This comment on tem- 
porary hospitals, it will be noted, was made 
some seven years after Barton's statement. 

A letter from Captain Chauncey, Decem- 
ber 24, 1 810, then in command of the Navy 
Yard, New York, to the Secretary of the 
Navy may be quoted as indicating the 
character of the sick quarters on that 
station : 

"I conceive it to be my duty to avail 
myself of this opportunity to call your at- 
tention to the situation of the sick on this 
station, and the particular hardship upon 
officers who may contract disease in the 



execution of their official duties, to be 
obliged to take lodgings at great expense, 
which frequently subjects them to pe- 
cuniary embarrassment, or to be placed 
in common with the sailors and marines 
in a large room that is neither wind nor 
water tight. To give you some faint idea 
of what is called the hospital on this sta- 
tion, imagine to yourself an old mill, situ- 
ated upon the margin of a millpond where 
every high tide flows from twelve to fif- 
teen inches upon the lower floor and 
there deposits a quantity of mud and 
sediment, and which has no other cover- 
ing to protect the sick from the inclem- 
ency of the season, than a common 
clap-board outside without any lining or 
ceiling on the inside. If, Sir, you can figure 
to yourself such a place, you will have 
some idea of the situation of the men on 
this station." 

It does not appear, therefore, that Dr. 
Barton in his statement of fact regarding 
the sick quarters at Philadelphia had repre- 
sented a condition which was peculiar to 
any one place in the naval establishment of 
those days, but one more or less character- 
istic of several. Under date of September 20, 
1816, there appears a letter in the files of 
the Navy Department from Dr. Barton, 
enclosing one from his father, both of which 
were addressed to James Monroe, then 
Secretary of State. These letters solicited a 
favorable recommendation of Dr. Barton to 
the notice of the Secretary of the Navy, the 
Hon. Benj. W. Crowninshield, or to his 
assistant, Mr. Homans. Whether as a result 
of this correspondence or not, is not certain, 
but on September 30, 1816, Dr. Barton was 
ordered to report to Commodore Murray at 
the Philadelphia Navy Yard for duty, pre- 
sumably as surgeon to the Marines. On No- 
vember 7, 1 81 7, he attained his real goal, 
by being ordered to the Naval Hospital, 
superseding a junior, Dr. Thomas Harris, 
in that position. This supercession of Dr. 



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Harris created ill feeling on the Iatter's part, 
and led to the court-martial of Barton in 
January, 1818, on charges preferred against 
him by Harris. The circumstances preceding 
this action were rather complex, but some- 
what as follows: In November, 1817, Dr. 
Barton's father had succumbed to his last 
illness at Lancaster, and after settling his 
father's affairs there, Barton had proceeded 
to Washington, armed with a letter of intro- 
duction from Richard Rush, Esq., 6 to Presi- 
dent James Monroe. Barton duly presented 
his letter, made his call on the President and 
asked for a more extended interview, which 
was granted him on the evening of the same 
day. At this interview Barton pressed his 
claim for duty at the Naval Hospital at 
Philadelphia. With President Monroe favor- 
ably inclined toward him, and armed also 
with a letter from Decatur to the Secretary, 
recommending him "for any vacancy that 
may exist in the line of his profession," he 
approached Mr. Homans, acting in Mr. 
Crowninshield's absence, and his orders to 
the Hospital soon followed. In acting in the 
manner described, Dr. Harris considered 
that Dr. Barton had treated him unfairly, 
and he proceeded to bring charges, founded 
partly on this incident and partly on the 
statement in his book, derogatory, as he 
thought, to Dr. Cutbush, which has already 
been alluded to. While the charges against 
Barton were pending, he received a note 
from Commodore Alexander Murray, in 
command of the Philadelphia station, asking 
for his resignation, or, as an alternative, an 
order of arrest. Barton's reply, I think, is 
worth quoting: 

"Sir: I have received your note of the 
10th Dec. 18 1 7, by Capt. Brown, in which 
you say 'Capt. Brown is empowered by 
me to offer you the alternative of resign- 
ing your commission as surgeon in the 
Navy of the United States or to hand you 

8 Secretary of State under Monroe, later minister 
to Great Britain. 



your arrest'; and in reply to it I have to 
say, that conscious of the strictest pro- 
priety in my conduct relative to the sta- 
tion of Hospital Surgeon of this place, I 
have not one minute's hesitation in 
rejecting the alternative proposed." 

The court-martial which was convened at 
Philadelphia January 7,1818, charged Barton 
with "conduct unbecoming an officer and a 
gentleman," with two specifications in sup- 
port of the charge, the first of which related 
to a statement in Dr. Barton's book on "Ma- 
rine Hospitals," previously mentioned, criti- 
cizing the condition of the hospital at Phila- 
delphia, which Harris claimed tended falsely 
to degrade the character and reputation of 
Barton's predecessor there, Dr. Edward 
Cutbush, who at the time was surgeon in 
charge. The court ruled that no answer or 
refutation need be made to this specification 
of the charge. The second specification of 
the charge that Barton had, while surgeon to 
the Marines at the Navy Yard, Phila- 
delphia, "insidiously solicited and procured 
Dr. Thomas Harris to be superseded and 
removed from his place at the Hospital, and 
obtained it for himself." It appears that 
Barton had "jocosely" remarked to Harris 
sometime prior to the time he was called 
away to attend his father's funeral, that he 
(Dr. Harris) had better look to his position 
at the hospital as he intended getting it for 
himself if he could, especially as his seniority 
entitled him to it. The court decided that 
the charge was sustained "to a certain extent 
only" and acquitted Dr. Barton of having 
uttered a wilful and deliberate falsehood. 
"The court deemed it derogatory, however, 
to the honor of the service, . . this shuffling 
for particular places, presumed to be given 
according to seniority or merit and which 
should ever be left to flow from the spon- 
taneous choice of the guardians of our in- 
terests and our rights," and sentenced the 
accused to be reprimanded by the Secretary 
of the Navy. The court also stated in the 



William Paul Crillon Barton 



285 



letter of reprimand that they "were pe- 
culiarly struck with the number and weight 
of testimonials adduced in relation to your 
talents, your usefulness and heretofore hon- 
orable deportment." 

This court-martial was unique in many 
respects, particularly in that President 
Monroe was summoned as a witness for the 
defense. On the back of the summons he 
stated that official business would prevent 
his appearance, but he submitted full an- 
swers to the interrogatories sent him, and 
these were favorable to Barton. On his trial 
Dr. Barton introduced a long forty-eight 
page letter of defense, which is a remarkable 
literary production, unfortunately much too 
long to include here, but I think his final 
peroration is worthy of presentation : 

"I yet firmly believe the reality will 
sooner or later appear. There is an in- 
vincible strength and boldness in truth 
that rends whatever cloak dishonesty 
may put over it; and despite of every un- 
toward effort to conceal it from view, it 
fearlessly shows its face! Well for the inno- 
cent that this is so and woe to the one 
who meddles with and disturbs the calm 
and consistent operation of honest policy! 
A short lived triumph may be his boon, 
but remorse must soon destroy it and in 
the fullest conviction I believe with the 
poet: 

There surely is some guiding power 
Which rightly suffers wrong, 
Gives vice to bloom its little hour 
But virtue late and long!" 

The letter of introduction from Richard 
Rush to President James Monroe, which has 
been referred to above, contained senti- 
ments of warm esteem and appreciation of 
Barton's professional standing. It refers to 
him as enjoying and in a very high degree 
deserving "the respect and esteem of all who 
have had the pleasure of his acquaintance. 
In speaking of his service in the Navy, Rush 
states that "he (Barton) exercises its duties 



(i.e., duties of his calling) with equal credit 
to himself and advantage to the service . . . 
the opportunities of a long acquaintance 
enables me to certify, in the warmest terms 
to his permanent worth." In answering the 
interrogatories sent to him by the court, 
President Monroe referred to Dr. Barton 
as follows: "My own impression was also 
favorable to him proceeding from what Mr. 
Rush had said, from my great respect for 
some of his relations, distinguished for their 
literary attainments, and the interest I took 
in the welfare of his mother. My impression 
now is that the Doctor urged his claim in 
his observations to me with delicacy towards 
his opponent and modesty to himself." 

Between the years 18 14 to 181 8, during 
his period of duty at Philadelphia, he com- 
pleted and published two works on botany, 
one, the "Vegetable Materia Medica of the 
United States, or Medical Botany," con- 
taining a botanical, general, and medical 
history of medicinal plants indigenous to the 
United States, a two volume work, and the 
other the "Compendium Florae Philadel- 
phiae," containing a description of the in- 
digenous and naturalized plants found 
within a circuit of ten miles of Philadelphia, 
also in two volumes. On October 17, 1814, 
he read a paper before the Linnaean Society, 
of which he was president, on Holcus bi- 
color, a plant used in Lancaster as a substi- 
tute for chocolate. In the year 1820, there 
appeared his "Memorial from the Professor 
of Botany in the University of Pennsyl- 
vania, to the Trustees of that Institution," 
praying for the removal of the professorship 
of botany from the faculty of natural sci- 
ence to the medical faculty, and urging that 
botany be added to the subjects requisite 
for the attainment of a medical degree. 

These works reveal Barton as a scientist 
of great ability and are evidence of his zeal 
in rendering available a knowledge of the 
general and medical botany of the United 
States. 

Barton's fellowship in the College of 



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Physicians lapsed for some reason in June, 
1822, and, while there is little evidence to 
support this view, it is thought that this 
may have been the result of some local dis- 
agreement growing out of the movement to 
found another medical school at Philadelphia 
at about this time. As early as 181 8, Bar- 
ton had endeavored to obtain a charter for 
a new medical college, but this was strenu- 
ously opposed by friends of the University 
of Pennsylvania, and the efforts of Barton 
and his associates proved unsuccessful. 
Seven years later, however, the Jefferson 
Medical College was established. 

At this time or a little later Barton ap- 
pears to have been placed on half pay, and 
in 1823, there is evidence that he lost even 
this income from the government, for in a 
letter addressed to the Secretary of the 
Navy, dated April 26, 1823, he refers to 
being "cut off from pay by Act of Congress 
one year ago." In speaking of his circum- 
stances in this letter, he refers to his writings 
as quite unremunerative, and of his salary 
as professor of botany as being only $120.00 
a year, "but even this has not been available 
for the present year as there was no class in 
botany." The letter finally leads up to a re- 
quest to be allowed to remain in Philadelphia 
for financial reasons, and because of the 
state of his health, which is attested as 
unsatisfactory by three physicians whose 
certificates he encloses. On April 23, 1823, 
in spite of the foregoing he is ordered to pro- 
ceed by water to Norfolk and join the "Con- 
gress." A letter follows, promptly written 
to President James Monroe, requesting the 
revocation of the orders, on account of an 
engagement he has entered into, to finish a 
book entitled, "A Flora of North America," 
which it develops is dedicated to Monroe. 
This book is to be illustrated by colored 
figures, drawn from nature by Barton, and 
colored by his wife. His orders to the "Con- 
gress" were revoked May 1st. On Nov